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Individual

DR. WILLIAM ISAIAH PARK III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
6144 AIRPORT BLVD, MOBILE, AL 36608-3143
(251) 476-5050
(251) 450-2770
Mailing address
PO BOX 86144, MOBILE, AL 36689-6144
(251) 476-5050
(251) 450-2770

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
00007045
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000079368
AL
05
00118992
MS
01
051079368
BCBS
AL
01
200018979
BCBS
MS
01
200028684
RAILROAD MEDICARE
AL
Enumeration date
05/01/2006
Last updated
01/20/2010
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