Individual
DR. JENNIFER CHRISTINE PARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
105 HANES SQUARE CIR, WINSTON SALEM, NC 27103-5514
(336) 441-5569
(336) 771-1907
Mailing address
PO BOX 751803, CHARLOTTE, NC 28275-1803
(336) 718-1000
(336) 718-1050
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
2006-01163
NC
207P00000X
Emergency Medicine Physician
200601163
NC
207Q00000X
Family Medicine Physician
Primary
2006-01163
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2057165A
—
NC
Enumeration date
08/05/2006
Last updated
08/19/2021
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