Provider Demographics
NPI:1942496005
Name:PARKS, JAMES ROBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ROBERT
Last Name:PARKS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:102 E SUNBRIDGE DR
Mailing Address - Street 2:SUITE 1
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-2830
Mailing Address - Country:US
Mailing Address - Phone:479-790-4889
Mailing Address - Fax:479-935-3159
Practice Address - Street 1:102 E SUNBRIDGE DR
Practice Address - Street 2:SUITE 1
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-2830
Practice Address - Country:US
Practice Address - Phone:479-790-4889
Practice Address - Fax:479-935-3159
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-21
Last Update Date:2012-11-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AR9029673832084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry