Healthcare Provider Details

I. General information

NPI: 1114172368
Provider Name (Legal Business Name): ANGELA FAY PARKS P.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANGELA F ARMOUR P.A.

II. Dates (important events)

Enumeration Date: 12/01/2008
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HOSPITAL DR
COLUMBIA MO
65212-0001
US

IV. Provider business mailing address

PO BOX 843966
KANSAS CITY MO
64184-3966
US

V. Phone/Fax

Practice location:
  • Phone: 573-882-1515
  • Fax: 573-884-4249
Mailing address:
  • Phone: 573-884-3300
  • Fax: 573-884-0943

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number2026017175
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberT-02258
License Number StateKS
# 3
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number1501255
License Number StateKS
# 4
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number4169
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: