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Individual

CLAYTON GERALD PARKS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2200 LAKE VICTORIA DR, SPRINGFIELD, IL 62703-5596
(217) 529-9266
(217) 529-9151
Mailing address
2200 LAKE VICTORIA DR, SPRINGFIELD, IL 62703-5596
(217) 529-9266
(217) 529-9151

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036150659
IL
2084P0800X
Psychiatry Physician
Primary
036150659
IL
2084P0800X
Psychiatry Physician
125069730
IL
2084P0800X
Psychiatry Physician
A173514
CA

Other

Enumeration date
05/22/2015
Last updated
10/15/2024
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