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General NPI Number Information
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NPI Number | 1902077407
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Entity Type | Organization
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Legal Business Name | JOSEPH K. PARKS, P.C.
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Dates
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Enumeration Date | 03/12/2008
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Last Update Date | 03/12/2008
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Provider Practice Location Address
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Address Line | 127 VILLAGE DR SUITE 300
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City | BELGRADE
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State | MT
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Zip | 59714-9617
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Country | US
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Telephone | 406-388-9661
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Fax | 406-388-9662
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Provider Business Mailing Address
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Address Line | 127 VILLAGE DR SUITE 300
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City | BELGRADE
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State | MT
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Zip | 59714-9617
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Country | US
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Telephone | 406-388-9661
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Fax | 406-388-9662
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOSEPH KYLE PARKS
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Credential | O.D.
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Telephone | 406-388-9661
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 774
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License Number State | MT
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