MEDICARE: DR. JOSEPH J. PARKS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	4301510506	MI
2	2084P0800X	Psychiatry Physician	ME157686	FL
3	2084P0800X	Psychiatry Physician	0101281040	VA
4	2084P0800X	Psychiatry Physician	102804	MO
5	2084P0800X	Psychiatry Physician	317259	NY
6	2084P0800X	Psychiatry Physician	35.055167	OH
7	2084P0800X	Psychiatry Physician	MD61440922	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1003898495	OTHER	MO	NPI NUMBER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003898495
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH J. PARKS M.D.

Provider Business Mailing Address
First Line	:	FAMILY HEALTH CENTER OF BOONE COUNTY
Second Line	:	1001 WEST WORLEY
City	:	COLUMBIA
State	:	MO
Zip	:	35203-2037
Country	:	US
Telephone Number	:	573-214-2314
Fax Number	:	573-814-2784

Provider Business Practice Location Address
First Line	:	FAMILY HEALTH CENTER OF BOONE COUNTY
Second Line	:	1001 WEST WORLEY
City	:	COLUMBIA
State	:	MO
Zip	:	35203-2037
Country	:	US
Telephone Number	:	573-214-2314
Fax Number	:	573-814-2784

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/19/2005
Last Update Date	:	01/02/2025

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