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NPI Code Detail

MEDICARE: SHERRY L PARKS PA C

MEDICARE: SHERRY L PARKS PA C
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
1363AM0700XMedical Physician Assistant001324IA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1970019183OTHERIARR MEDICARE

General Provider Information

NPI Number : 1568459329
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHERRY L PARKS PA C
Provider Business Mailing Address
First Line : 401 1ST AVE
Second Line :
City : TOLEDO
State : IA
Zip : 52342-2129
Country : US
Telephone Number : 641-484-2602
Fax Number : 641-484-6387
Provider Business Practice Location Address
First Line : 401 1ST AVE
Second Line :
City : TOLEDO
State : IA
Zip : 52342-2129
Country : US
Telephone Number : 641-484-2602
Fax Number : 641-484-6387
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/05/2005
Last Update Date : 04/27/2010

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Directions to “ SHERRY L PARKS PA C” Practice Location

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