Individual
MR. GERALD Y PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1950 DIAMOND PKWY STE 200, NORTH KANSAS CITY, MO 64116-4321
(816) 842-6717
(816) 842-2574
Mailing address
1950 DIAMOND PKWY STE 200, NORTH KANSAS CITY, MO 64116-4321
(816) 842-6717
(816) 842-2574
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
0432487
KS
208800000X
Urology Physician
Primary
2000158331
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
27244012
BCBS
—
01
—
340018272
RAILROAD MEDICARE
—
Enumeration date
05/12/2006
Last updated
04/12/2021
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