Provider Demographics
NPI:1417115742
Name:PARKS, RONALD R (MD)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:R
Last Name:PARKS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1070-1 TUNNEL RD., STE. 10, #274
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28805-2848
Mailing Address - Country:US
Mailing Address - Phone:828-230-7004
Mailing Address - Fax:828-393-5259
Practice Address - Street 1:20 SPRING HOLLOW CIRCLE
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28805-2848
Practice Address - Country:US
Practice Address - Phone:828-230-7004
Practice Address - Fax:828-277-5757
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-22
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200000571207R00000X, 2084P0800X, 2083P0500X, 2084A0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine
No2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCB74562Medicare UPIN