Individual
JOHN TICE PARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3924 MINNESOTA AVE. NE, UNITY HEALTHCARE - MINNESOTA AVENUE CLINIC, WASHINGTON, DC 20019
(202) 398-8683
(202) 627-7815
Mailing address
3924 MINNESOTA AVE. NE, UNITY HEALTHCARE - MINNESOTA AVENUE CLINIC, WASHINGTON, DC 20019
(202) 398-8683
(202) 627-7815
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD041594
DC
390200000X
Student in an Organized Health Care Education/Training Program
164607
NC
Other
Enumeration date
05/06/2010
Last updated
07/31/2013
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