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NPI Code Detail

MEDICARE: DR. MATTHEW LEE PARKE DO

MEDICARE: DR. MATTHEW LEE PARKE DO
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
1207ZP0102XAnatomic Pathology & Clinical Pathology Physician2024033210MO
2207ZC0500XCytopathology Physician2024033210MO

General Provider Information

NPI Number : 1275039216
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MATTHEW LEE PARKE DO
Provider Business Mailing Address
First Line : PO BOX 7406
Second Line :
City : COLUMBIA
State : MO
Zip : 65205-7406
Country : US
Telephone Number : 573-886-4608
Fax Number :
Provider Business Practice Location Address
First Line : 300 PORTLAND ST STE 110
Second Line :
City : COLUMBIA
State : MO
Zip : 65201-7390
Country : US
Telephone Number : 573-886-4608
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/30/2018
Last Update Date : 03/02/2026

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Directions to “ DR. MATTHEW LEE PARKE DO” Practice Location

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