Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Parker P Haberstroh

Individual provider Physical Therapist · NPI 1043084163

Parker P Haberstroh is a Physical Therapist in Private Practice in Southaven, Mississippi. Qualified in 2023, 3 years ago. Practices with Athletico Ltd, a 2,186-clinician group and accepts Medicare assignment. Licensed in Mississippi.

Years since qualifying
3
Licensed in
MS
In the registry since
2023
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Practice location Address checks out

1100 Church Rd W Ste 112
Southaven, MS 38671-7154
Phone: (662) 548-3650
Fax: (662) 654-8029
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence PT7508 (MS)

Record details

NPI number1043084163
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedNovember 9, 2023
Last updated in NPPESNovember 9, 2023
Certification dateNovember 9, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Athletico Ltd — 2186 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Southaven