Organization
THE PARK CLINIC FOR COSMETIC AND RECONSTRUCTIVE SURGERY, P.C.
Active
Parent organization
MOBILE PLASTIC AND RECONSTRUCTIVE SURGERY AND DERMATOLOGY
Organization subpart
Yes
Provider details
NPI number
Legal business name
MOBILE PLASTIC AND RECONSTRUCTIVE SURGERY AND DERMATOLOGY
Authorized official
CHRISTOPHER A PARK M.D. (PRESIDENT)
(251) 340-6600
Entity
Organization
Contact information
Practice address
3153 DAUPHIN ST, MOBILE, AL 36606-4061
(251) 340-6600
Mailing address
PO BOX 852047, MOBILE, AL 36685-2047
(251) 340-6600
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
MD.28938
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
510G700432
MEDICARE PTAN
AL
01
—
51595045
BLUE CROSS BLUE SHIELD AL
AL
Enumeration date
09/03/2008
Last updated
03/18/2009
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us