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Individual

DR. KENNETH SCOTT PARKS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
801 POINCIANA AVE, MAMOU, LA 70554-2298
(337) 468-0355
Mailing address
801 POINCIANA AVE, MAMOU, LA 70554-2298
(337) 468-0355

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
019463
LA
207R00000X
Internal Medicine Physician
Primary
MD019463
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1397521
LA
Enumeration date
06/02/2006
Last updated
05/27/2025
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