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Organization
PARKSTONE MEDICAL ASSOCIATES
Active
Organization
PARKSTONE MEDICAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DONALD B PARKS M.D. (MEDICAL DIRECTOR)
(215) 229-2022
Entity
Organization
Contact information
Practice address
2304 N BROAD STREET, SPACE B, PHILADELPHIA, PA 19132
(215) 229-2022
(215) 229-2048
Mailing address
2304 N BROAD STREET, SPACE B, PHILADELPHIA, PA 19132
(215) 229-2022
(215) 229-2048
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD023038E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000807374
HIGHMARK BLUE SHIELD ID
PA
Enumeration date
07/10/2006
Last updated
03/28/2019
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