Waylon Morris Parker, MD

Individual provider Active NPI General Practice Physician · Jackson, LA

NPI 1609914902 · NPPES record last updated Nov 24, 2009

Key facts

NPI
1609914902
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Physician 208D00000X
License
016672 (LA)
Practice address
5002 Highway 10
Villa Feliciana Medical Complex
Jackson, LA 70748
Phone
(225) 634-4079
NPI assigned
Feb 1, 2007
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
HHS exclusion list flag
The National Provider Directory flags this NPI as appearing on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Villa Feliciana Medical Complex Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 016672 LA
General Practice Physician 208D00000X 016672 LA Yes

Addresses

Primary practice location

5002 Highway 10
Villa Feliciana Medical Complex
Jackson, LA 70748

Mailing address

5635 Main Street
Suite a #222
Zachary, LA 70791
Phone (225) 634-4079

Other providers in Jackson, LA

All providers in Jackson, LA · General Practice Physician in Louisiana

Sources for this page

Verify at the official NPI Registry.