Individual
DR. JOHN LIGHT PARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100 PILOT MEDICAL DR STE 300, BIRMINGHAM, AL 35235
(205) 856-2284
(205) 815-4777
Mailing address
100 PILOT MEDICAL DR STE 300, BIRMINGHAM, AL 35235-3412
(205) 856-2284
(205) 815-4777
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
33880
SC
207RI0011X
Interventional Cardiology Physician
21255
MS
207RI0011X
Interventional Cardiology Physician
Primary
37071
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04006251
—
MS
05
—
215882
—
AL
Enumeration date
07/06/2008
Last updated
06/20/2018
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