Provider Demographics
NPI:1639580574
Name:PARKS, JOSEPH ABRAHAM (DO)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:ABRAHAM
Last Name:PARKS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:3200 WESTHILL DR STE 102
Mailing Address - Street 2:
Mailing Address - City:WAUSAU
Mailing Address - State:WI
Mailing Address - Zip Code:54401-4706
Mailing Address - Country:US
Mailing Address - Phone:715-847-2019
Mailing Address - Fax:715-847-2668
Practice Address - Street 1:3200 WESTHILL DR STE 102
Practice Address - Street 2:
Practice Address - City:WAUSAU
Practice Address - State:WI
Practice Address - Zip Code:54401-4706
Practice Address - Country:US
Practice Address - Phone:715-847-2019
Practice Address - Fax:715-847-2668
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-14
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE13962083A0100X
WI77066-212081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Multi-Specialty
No2083A0100XAllopathic & Osteopathic PhysiciansPreventive MedicineAerospace Medicine