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General NPI Number Information
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NPI Number | 1235186651
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Entity Type | Individual
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Provider Name | PAUL FRANCIS PARK MD
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Gender | Male
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Dates
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Enumeration Date | 05/30/2006
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Last Update Date | 09/20/2012
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Provider Practice Location Address
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Address Line | 200 MONTGOMERY HWY STE# 100
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City | VESTAVIA HILLS
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State | AL
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Zip | 35216-1842
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Country | US
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Telephone | 205-421-2114
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Fax | 205-201-7775
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Provider Business Mailing Address
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Address Line | 2147 RIVERCHASE OFFICE RD
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City | BIRMINGHAM
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State | AL
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Zip | 35244-1836
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Country | US
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Telephone | 205-403-8902
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Fax | 205-982-0278
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 16962
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License Number State | AL
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