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General NPI Number Information
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NPI Number | 1982716072
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Entity Type | Organization
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Legal Business Name | RICHARD F. PARK, M.D.PSC
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1708 FOREST DR
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City | CORBIN
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State | KY
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Zip | 40701-2327
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Country | US
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Telephone | 606-528-6437
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Fax | 606-528-7881
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Provider Business Mailing Address
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Address Line | 1708 FOREST DR
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City | CORBIN
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State | KY
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Zip | 40701-2327
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Country | US
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Telephone | 606-528-6437
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Fax | 606-528-7881
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RICHARD F PARK
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Credential | M.D.
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Telephone | 606-528-6437
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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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