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NPI Code Detail

MEDICARE: MR. DAVID ALAN PARKS MD

MEDICARE: MR. DAVID ALAN PARKS MD
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
1207R00000XInternal Medicine Physician105677MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1649315219
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. DAVID ALAN PARKS MD
Provider Business Mailing Address
First Line : 3960 LINDELL BLVD
Second Line :
City : ST LOUIS
State : MO
Zip : 63108-3204
Country : US
Telephone Number : 314-652-0100
Fax Number : 314-531-1768
Provider Business Practice Location Address
First Line : 3960 LINDELL BLVD
Second Line :
City : ST LOUIS
State : MO
Zip : 63108-3204
Country : US
Telephone Number : 314-652-0100
Fax Number : 314-652-0125
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/21/2007
Last Update Date : 07/21/2010

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Practice Location Address:
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1831691435 — LISA SANDERS
Practice Location Address:
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Directions to “ MR. DAVID ALAN PARKS MD” Practice Location

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