Individual
PAMELA S. PARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
400 W 16TH ST, PUEBLO, CO 81003-2745
(719) 584-4306
(719) 595-7886
Mailing address
400 W 16TH ST, PUEBLO, CO 81003-2745
(719) 584-4306
(719) 595-7886
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
31340
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01313402
—
CO
Enumeration date
11/22/2005
Last updated
03/14/2009
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