William L Park, OD, LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

1798 Issued in KS

Legal business name

WILLIAM L PARK, OD, LLC

Practice address

610 N Main St
Suite 201
Wichita, KS 67203-3601

Phone

(316) 440-1690

Fax

(316) 440-1695

NPI assigned

Jul 22, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. William L Park, OD

Title

Member

Phone

(316) 440-1690

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1216684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302739200000",
    "number": "1003071887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 N MAIN ST",
            "address_2": "SUITE 201",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672033601",
            "telephone_number": "316-440-1690",
            "fax_number": "316-440-1695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 N MAIN ST",
            "address_2": "SUITE 201",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672033601",
            "telephone_number": "316-440-1690",
            "fax_number": "316-440-1695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM L PARK, OD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-22",
        "last_updated": "2011-04-14",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "316-440-1690",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "KS",
            "license": "1798",
            "primary": true
        },
        {
            "code": "152WL0500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "KS",
            "license": "1798",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "KA1156",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Willey
• Stephanie Nicole Willey, BCABA
• Susan Marie Willey, PT
• William E. Papineau, PH.D., P.a.
• William H Scott, MD PA
• William P. Scobee, D.C. P.a.
• Alicia Nicole Williams
• Amity Marie Williams, RN
• Amy Williams
• Amy Williams

• All providers in Wichita, KS
• Optometrist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.