Organization
PARK PLASTIC SURGERY, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FREDERICK K. PARK MD (OWNER)
(252) 937-5003
Entity
Organization
Contact information
Practice address
4008 CAPITAL DR, ROCKY MOUNT, NC 27804-3123
(252) 937-5003
(252) 937-3020
Mailing address
PO BOX 13219, DURHAM, NC 27709-3219
(252) 937-5003
(252) 937-3020
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
36793
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1265533806
—
NC
Enumeration date
09/26/2006
Last updated
01/07/2026
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