# JOHN TICE PARKS

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1942528518
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | MD041594 | DC | Yes |
| 390200000X | Student in an Organized Health Care Education/Training Program | 164607 | NC | — |

## Other

- **Enumeration date:** 05/06/2010
- **Last updated:** 07/31/2013