Provider Demographics
NPI:1457507592
Name:PARKS, LAURA PIAZZA (MD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:PIAZZA
Last Name:PARKS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:LAURA
Other - Middle Name:KATHRYN
Other - Last Name:PIAZZA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:12 OFFICE PARK CIR
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN BRK
Mailing Address - State:AL
Mailing Address - Zip Code:35223-2521
Mailing Address - Country:US
Mailing Address - Phone:205-933-0320
Mailing Address - Fax:205-933-6400
Practice Address - Street 1:12 OFFICE PARK CIR
Practice Address - Street 2:
Practice Address - City:MOUNTAIN BRK
Practice Address - State:AL
Practice Address - Zip Code:35223-2521
Practice Address - Country:US
Practice Address - Phone:205-933-0320
Practice Address - Fax:205-933-6400
Is Sole Proprietor?:No
Enumeration Date:2008-08-08
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS21636208000000X, 207RR0500X
SC34174208000000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS03124874Medicaid
MS03124874Medicaid