Provider Demographics
NPI:1447436746
Name:PARKER, STEPHEN T (MS,PES,EMT)
Entity type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:T
Last Name:PARKER
Suffix:
Gender:M
Credentials:MS,PES,EMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 TAMMY CT
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28560-8011
Mailing Address - Country:US
Mailing Address - Phone:252-571-9221
Mailing Address - Fax:
Practice Address - Street 1:600D FONTANA BLVD
Practice Address - Street 2:
Practice Address - City:HAVELOCK
Practice Address - State:NC
Practice Address - Zip Code:28532-3104
Practice Address - Country:US
Practice Address - Phone:252-444-5600
Practice Address - Fax:252-444-8966
Is Sole Proprietor?:No
Enumeration Date:2008-01-16
Last Update Date:2008-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer