Provider Demographics
NPI:1235759002
Name:PARKER, JAMES CLAYTON III (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:CLAYTON
Last Name:PARKER
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:808 VARSITY DR
Mailing Address - Street 2:
Mailing Address - City:TUPELO
Mailing Address - State:MS
Mailing Address - Zip Code:38801-4613
Mailing Address - Country:US
Mailing Address - Phone:662-377-3204
Mailing Address - Fax:
Practice Address - Street 1:408 COUNCIL CIR STE C
Practice Address - Street 2:
Practice Address - City:TUPELO
Practice Address - State:MS
Practice Address - Zip Code:38801-4949
Practice Address - Country:US
Practice Address - Phone:662-377-3376
Practice Address - Fax:662-377-3308
Is Sole Proprietor?:No
Enumeration Date:2020-04-22
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS33937207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology