Provider Demographics
NPI:1003898495
Name:PARKS, JOSEPH J (MD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:J
Last Name:PARKS
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Gender:M
Credentials:MD
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Mailing Address - Street 1:FAMILY HEALTH CENTER OF BOONE COUNTY
Mailing Address - Street 2:1001 WEST WORLEY
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:35203-2037
Mailing Address - Country:US
Mailing Address - Phone:573-214-2314
Mailing Address - Fax:573-814-2784
Practice Address - Street 1:FAMILY HEALTH CENTER OF BOONE COUNTY
Practice Address - Street 2:1001 WEST WORLEY
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:35203-2037
Practice Address - Country:US
Practice Address - Phone:573-214-2314
Practice Address - Fax:573-814-2784
Is Sole Proprietor?:No
Enumeration Date:2005-11-19
Last Update Date:2025-01-02
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Provider Licenses
StateLicense IDTaxonomies
MI43015105062084P0800X
FLME1576862084P0800X
VA01012810402084P0800X
MO1028042084P0800X
NY3172592084P0800X
OH35.0551672084P0800X
WAMD614409222084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1003898495OtherNPI NUMBER
MO206741324Medicaid