# CHRIS PARK DO PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Park Medical Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1831710623
- **Authorized official:** DR. CHRISTOPHER PARK DO (OWNER/PHYSICIAN)
- **Authorized official phone:** (662) 397-4597

## Contact information

- **Practice address:** 47 S MAIN ST, PONTOTOC, MS 38863-2823
- **Practice address phone:** (662) 499-2802
- **Mailing address:** PO BOX 507, PONTOTOC, MS 38863-0507
- **Mailing address phone:** (662) 308-7045

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/03/2020
- **Last updated:** 02/18/2024