Organization
J PARKS MEDICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES FREDERICK PARKS MD (OWNER/PHYSICIAN)
(770) 538-5734
Entity
Organization
Contact information
Practice address
1010 DAWSONVILLE HWY, GAINESVILLE, GA 30501-2621
(770) 533-8329
Mailing address
320 BROWN DR, CLERMONT, GA 30527-1753
(770) 538-5734
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
018176
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000114287D
—
GA
05
—
000114287E
—
GA
Enumeration date
10/24/2006
Last updated
07/10/2007
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