Individual
BERT E PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1515 W TRUMAN RD, SUITE 607, INDEPENDENCE, MO 64050-3436
(816) 833-0466
(816) 833-4155
Mailing address
1515 W TRUMAN RD, SUITE 607, INDEPENDENCE, MO 64050-3436
(816) 833-0466
(816) 833-4155
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
R7A63
MO
Other
Enumeration date
09/13/2005
Last updated
08/14/2007
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