Provider Demographics
NPI:1922093731
Name:PARKS, FRANK B (DO)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:B
Last Name:PARKS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6640 S 76TH EAST AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-1835
Mailing Address - Country:US
Mailing Address - Phone:918-629-3403
Mailing Address - Fax:918-254-6605
Practice Address - Street 1:6640 S 76TH EAST AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133-1835
Practice Address - Country:US
Practice Address - Phone:918-629-3403
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-19
Last Update Date:2013-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB07883700207P00000X
OK2250207P00000X
AK5557207P00000X
NMA1292-04207P00000X
MO2005015560207P00000X
KS0531271207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO204475503Medicaid
NJ0079316Medicaid
NJ092684SN3Medicare PIN
NJ092684UXKMedicare PIN
NJE84278Medicare UPIN
NJ0079316Medicaid
NJ092684Medicare ID - Type Unspecified