Individual
DR. RUSSELL DANIEL PARKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 KETTLE POINT AVE, EAST PROVIDENCE, RI 02914-5375
(401) 457-1500
Mailing address
PO BOX 1119, PROVIDENCE, RI 02901-1119
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
MD19127
RI
207XS0117X
Orthopaedic Surgery of the Spine Physician
341291
LA
Other
Enumeration date
04/18/2018
Last updated
07/19/2024
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