Provider Demographics
NPI:1760748172
Name:PARKS, CRYSTAL LEGAYLE (DO)
Entity Type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:LEGAYLE
Last Name:PARKS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:6701 AIRPORT BLVD STE D143
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36608-6701
Mailing Address - Country:US
Mailing Address - Phone:251-342-3949
Mailing Address - Fax:251-266-3361
Practice Address - Street 1:8010 MOFFETT RD
Practice Address - Street 2:
Practice Address - City:SEMMES
Practice Address - State:AL
Practice Address - Zip Code:36575-5406
Practice Address - Country:US
Practice Address - Phone:251-645-8946
Practice Address - Fax:251-645-8976
Is Sole Proprietor?:No
Enumeration Date:2012-04-10
Last Update Date:2019-01-30
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Provider Licenses
StateLicense IDTaxonomies
ALDO.1645207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine