Individual
DR. ANNIE PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
450 NORTHSIDE CHEROKEE BLVD, CANTON, GA 30115-8015
(770) 224-1000
(770) 224-2451
Mailing address
PO BOX 2705, HUNTSVILLE, AL 35804-2705
(256) 265-3880
(256) 265-3886
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
079236
GA
207R00000X
Internal Medicine Physician
1688
AL
208M00000X
Hospitalist Physician
Primary
79236
GA
Other
Enumeration date
06/26/2013
Last updated
01/10/2020
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