Provider Demographics
NPI:1023331675
Name:PARKS, SARAH ELIZABETH (MD)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:ELIZABETH
Last Name:PARKS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 HAWTHORNE ST
Mailing Address - Street 2:
Mailing Address - City:GRETNA
Mailing Address - State:LA
Mailing Address - Zip Code:70056-7039
Mailing Address - Country:US
Mailing Address - Phone:504-368-0504
Mailing Address - Fax:
Practice Address - Street 1:1816 INDUSTRIAL BLVD
Practice Address - Street 2:
Practice Address - City:HARVEY
Practice Address - State:LA
Practice Address - Zip Code:70058-2314
Practice Address - Country:US
Practice Address - Phone:504-366-7638
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-11
Last Update Date:2011-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA0159892083P0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0011XAllopathic & Osteopathic PhysiciansPreventive MedicineUndersea and Hyperbaric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1336572Medicaid
LA1336572Medicaid
LA5M739Medicare PIN