MEDICARE: DR. RONALD R PARKS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	200000571	NC
2	2084P0800X	Psychiatry Physician	200000571	NC
3	2083P0500X	Preventive Medicine/Occupational Environmental Medicine Physician	200000571	NC
4	2084A0401X	Addiction Medicine (Psychiatry & Neurology) Physician	200000571	NC

General Provider Information

NPI Number	:	1417115742
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RONALD R PARKS M.D.

Provider Business Mailing Address
First Line	:	1070-1 TUNNEL RD., STE. 10, #274
Second Line	:
City	:	ASHEVILLE
State	:	NC
Zip	:	28805-2848
Country	:	US
Telephone Number	:	828-230-7004
Fax Number	:	828-393-5259

Provider Business Practice Location Address
First Line	:	20 SPRING HOLLOW CIRCLE
Second Line	:
City	:	ASHEVILLE
State	:	NC
Zip	:	28805-2848
Country	:	US
Telephone Number	:	828-230-7004
Fax Number	:	828-277-5757

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/22/2008
Last Update Date	:	06/01/2023

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