Provider Demographics
NPI:1952487258
Name:RALPH A. PARKS,M.D.P.C.
Entity Type:Organization
Organization Name:RALPH A. PARKS,M.D.P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTHOPAEDIC SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:A
Authorized Official - Last Name:PARKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:276-783-9752
Mailing Address - Street 1:1209 SNIDER ST
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:VA
Mailing Address - Zip Code:24354-4221
Mailing Address - Country:US
Mailing Address - Phone:276-783-9752
Mailing Address - Fax:276-783-7786
Practice Address - Street 1:1209 SNIDER ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:VA
Practice Address - Zip Code:24354-4221
Practice Address - Country:US
Practice Address - Phone:276-783-9752
Practice Address - Fax:276-783-7786
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-29
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101235885207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010048281Medicaid
VA104318OtherANTHEM
VA5116970001Medicare NSC
VA010048281Medicaid
VACO9055Medicare PIN