Paul Francis Park, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

16962 Issued in AL

Practice address

200 Montgomery Hwy
Ste# 100
Vestavia Hills, AL 35216-1842

Phone

(205) 421-2114

Fax

(205) 201-7775

NPI assigned

May 30, 2006

Last updated

Sep 20, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 6

Other names 1

• Paul F Park Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1148947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348099200000",
    "number": "1235186651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2147 RIVERCHASE OFFICE RD",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352441836",
            "telephone_number": "205-403-8902",
            "fax_number": "205-982-0278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MONTGOMERY HWY",
            "address_2": "STE# 100",
            "city": "VESTAVIA HILLS",
            "state": "AL",
            "postal_code": "352161842",
            "telephone_number": "205-421-2114",
            "fax_number": "205-201-7775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "PAUL",
        "middle_name": "FRANCIS",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-30",
        "last_updated": "2012-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AL",
            "license": "16962",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000031339",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN # ESTABLISH 2009",
            "identifier": "102I027856",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AL BCBS # AFC VESTAVIA",
            "identifier": "515-97129",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "020050785",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID/EDS AFC VESTAVIA HILLS",
            "identifier": "117861",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "51046120",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAUL",
            "last_name": "PARK",
            "middle_name": "F",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Surgery Physician in Vestavia Hills, AL
• Providers in Vestavia Hills, AL by specialty
• Surgery Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2012; 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.