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NPI Code Detail

MEDICARE: LANCE PARKS PA-C

MEDICARE: LANCE 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
1363A00000XPhysician Assistant13295GA

General Provider Information

NPI Number : 1699648618
Entity Type Code : Individual
Provider Name (Legal Business Name) : LANCE PARKS PA-C
Provider Business Mailing Address
First Line : 95 COLLIER RD NW STE 2045
Second Line :
City : ATLANTA
State : GA
Zip : 30309-1723
Country : US
Telephone Number : 404-605-5110
Fax Number : 404-609-7334
Provider Business Practice Location Address
First Line : 95 COLLIER RD NW STE 2045
Second Line :
City : ATLANTA
State : GA
Zip : 30309-1723
Country : US
Telephone Number : 404-605-5110
Fax Number : 404-609-7334
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/25/2025
Last Update Date : 01/14/2026

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Directions to “ LANCE PARKS PA-C” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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