Healthcare Provider Details

I. General information

NPI: 1225421126
Provider Name (Legal Business Name): PARKE PHYSICIANS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2015
Last Update Date: 03/04/2021
Certification Date: 03/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1210 KY HIGHWAY 36 E
CYNTHIANA KY
41031-7498
US

IV. Provider business mailing address

155 E MARKET ST 700
INDIANAPOLIS IN
46204-3294
US

V. Phone/Fax

Practice location:
  • Phone: 859-234-2300
  • Fax: 904-265-8181
Mailing address:
  • Phone: 800-526-6797
  • Fax: 800-456-6148

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ANDRE CREESE
Title or Position: PRESIDENT
Credential: MD
Phone: 800-526-6797