Individual
MR. PAUL FRANCIS PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 MONTGOMERY HWY, STE# 100, VESTAVIA HILLS, AL 35216-1842
(205) 421-2114
(205) 201-7775
Mailing address
2147 RIVERCHASE OFFICE RD, BIRMINGHAM, AL 35244-1836
(205) 403-8902
(205) 982-0278
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
16962
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000031339
—
AL
01
—
020050785
RAILROAD MEDICARE
AL
01
—
102I027856
MEDICARE PTAN # ESTABLISH 2009
AL
01
—
117861
MEDICAID/EDS AFC VESTAVIA HILLS
AL
01
—
51046120
BLUE CROSS BLUE SHIELD
AL
01
—
515-97129
AL BCBS # AFC VESTAVIA
AL
Enumeration date
05/30/2006
Last updated
09/20/2012
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