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General NPI Number Information
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NPI Number | 1952984460
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Entity Type | Organization
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Legal Business Name | OAK PARK HEALTH MANAGEMENT PLLC
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Dates
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Enumeration Date | 05/03/2021
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Last Update Date | 05/03/2021
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Provider Practice Location Address
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Address Line | 25900 GREENFIELD RD STE 140
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City | OAK PARK
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State | MI
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Zip | 48237-1267
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Country | US
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Telephone | 248-230-8829
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Fax |
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Provider Business Mailing Address
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Address Line | 25900 GREENFIELD RD STE 140
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City | OAK PARK
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State | MI
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Zip | 48237-1267
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Country | US
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Telephone | 248-230-8829
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | KEITH YOUNG
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Credential |
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Telephone | 248-230-8829
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number |
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License Number State |
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