Provider Demographics
NPI:1548279748
Name:PARKER, WILLIAM DARWIN (DC)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:DARWIN
Last Name:PARKER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6543 MONTECITO BLVD # B
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95409-2928
Mailing Address - Country:US
Mailing Address - Phone:707-538-5100
Mailing Address - Fax:707-569-1485
Practice Address - Street 1:6543 MONTECITO BLVD # B
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95409-2928
Practice Address - Country:US
Practice Address - Phone:707-538-5100
Practice Address - Fax:707-569-1485
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC22804111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U47182Medicare UPIN
CADC0228040Medicare ID - Type Unspecified