Provider Demographics
NPI:1437161437
Name:PARK FAMILY HEALTH CARE, P.C.
Entity Type:Organization
Organization Name:PARK FAMILY HEALTH CARE, P.C.
Other - Org Name:PARK MEDICAL CENTERS
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:HOWARD
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-356-5555
Mailing Address - Street 1:28212 FRANKLIN RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48034-1659
Mailing Address - Country:US
Mailing Address - Phone:248-356-5555
Mailing Address - Fax:248-356-5544
Practice Address - Street 1:12871 E JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48215-2754
Practice Address - Country:US
Practice Address - Phone:313-821-3900
Practice Address - Fax:313-821-1511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-12
Last Update Date:2020-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty