MEDICARE: DAVID A PARKS, MD, PC

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	261QP2300X	Primary Care Clinic/Center

General Provider Information

NPI Number	:	1992721260
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAVID A PARKS, MD, PC

Provider Business Mailing Address
First Line	:	3960 LINDELL BLVD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63108-3204
Country	:	US
Telephone Number	:	314-652-0100
Fax Number	:	314-652-0125

Provider Business Practice Location Address
First Line	:	3960 LINDELL BLVD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63108-3204
Country	:	US
Telephone Number	:	314-652-0100
Fax Number	:	314-652-0125

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. DAVID ALLAN PARKS
Credential	:	MD
Telephone Number	:	314-652-0100

Provider Enumeration Date	:	07/13/2006
Last Update Date	:	10/17/2007

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