Healthcare Provider Details

I. General information

NPI: 1962436329
Provider Name (Legal Business Name): CHRISTOPHER S PARKS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 CELEBRATE LIFE PARKWAY PULMONARY MEDICINE
NEWNAN GA
30265-8001
US

IV. Provider business mailing address

1364 CLIFTON RD NE HOSPTIAL MEDICINE DEPARTMENT
ATLANTA GA
30322-1059
US

V. Phone/Fax

Practice location:
  • Phone: 770-400-6000
  • Fax:
Mailing address:
  • Phone: 404-778-5334
  • Fax: 404-778-5435

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number49369
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number049369
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: