Individual
THOMAS M PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3334 CAPITAL MEDICAL BLVD, STE. 400, TALLAHASSEE, FL 32308-8405
(850) 877-8174
(850) 877-5636
Mailing address
3334 CAPITAL MEDICAL BLVD, STE. 400, TALLAHASSEE, FL 32308-8405
(850) 877-8174
(850) 877-5636
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
056205
GA
207X00000X
Orthopaedic Surgery Physician
Primary
ME85708
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000962739A
—
GA
05
—
000962739B
—
GA
05
—
264968300
—
FL
Enumeration date
05/24/2005
Last updated
01/03/2013
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