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Individual

ASHLEY L PARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1400 S GERMANTOWN RD, GERMANTOWN, TN 38138-2205
(901) 759-3100
(901) 759-3196
Mailing address
1400 S GERMANTOWN RD, GERMANTOWN, TN 38138-2205
(901) 759-3100
(901) 759-3196

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
26245
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
06629278
MS
05
100156885
MS
05
100156886
MS
05
100156887
MS
05
145915001
AR
05
Q016952
TN
Enumeration date
09/29/2005
Last updated
02/16/2023
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