Individual
DR. MARK JUSTIN PARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
717 S HOUSTON AVE STE 200, TULSA, OK 74127-9005
(918) 586-4500
(918) 586-4528
Mailing address
5310 E 31ST ST FL 13, TULSA, OK 74135-5018
(918) 561-5701
(918) 561-1173
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
6719
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200855730A
—
OK
01
—
2G4594
MEDICARE
OK
Enumeration date
02/16/2018
Last updated
02/10/2023
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