Parker, Stacey Ann

Parker, Stacey Ann is an individual health care provider with primary practice located at 4791 S Main St , Acworth GA 30101-5324. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Parker, Stacey Ann can be contacted via phone (770) 422-1400.

Contact Information

Primary practice address
4791 S Main St Acworth GA 30101-5324
Phone: (770) 422-1400
Fax: (678) 290-6728
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 060022 Georgia

Profile Details

NPI number 1891965281
LBN Legal business name Parker, Stacey Ann
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 3rd, 2008
Last updated Mar 23rd, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1891965281 NPPES
Georgia Other 060022 LICENSE
Georgia MEDICAID 120103132A LICENSE

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