Provider Demographics
NPI:1154655710
Name:PARKS, THOMAS E (PA)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:E
Last Name:PARKS
Suffix:
Gender:M
Credentials:PA
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Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1810 E PALM AVE
Mailing Address - Street 2:APT 1117
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33605-3938
Mailing Address - Country:US
Mailing Address - Phone:954-816-5059
Mailing Address - Fax:
Practice Address - Street 1:10461 QUALITY DR
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34609-9634
Practice Address - Country:US
Practice Address - Phone:352-688-3002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-29
Last Update Date:2012-03-28
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant