Northlake Family Medical Practice
NPI #1003928680 in Columbia, South Carolina
Provider Information
- NPI Number
- 1003928680
- Entity Type
- Organization
- Organization Name
- Northlake Family Medical Practice
- Primary Specialty
- Family Medicine
- Enumeration Date
- Aug 31, 2006
- Last Updated
- Oct 16, 2007
Practice Location
- Address
- 3000 NE MEDICAL PARK
- Address 2
- STE 101
- City
- Columbia
- State
- South Carolina
- ZIP Code
- 29223-6251
- Phone
- (803) 419-5131
Authorized Official
- Name
- DR. REGINALD L PARKER, MD
- Title
- OWNER
- Phone
- (803) 419-5131
Specialties & Taxonomy Codes
| Specialty |
|---|
| Family Medicine |
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