Will J Parks DDS MD PA

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

17107 Issued in TX

Legal business name

WILL J PARKS DDS MD PA

Practice address

815 S Fleishel Ave
Tyler, TX 75701-2017

Phone

(903) 526-7977

Fax

(903) 526-7989

NPI assigned

Mar 25, 2011

Organization subpart

No

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

Authorized official

Name

Will Parks Jr.

Title

Owner

Phone

(903) 526-7977

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Willie Joe Parks Jr., D.D.S., M.D.

  • Oral and Maxillofacial Surgery (Dentist)
  • Tyler, TX
  • NPI 1306918172
  NPD

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

{
    "created_epoch": "1301011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301011200000",
    "number": "1497054712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 S FLEISHEL AVE",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757012017",
            "telephone_number": "903-526-7977",
            "fax_number": "903-526-7989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 S FLEISHEL AVE",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757012017",
            "telephone_number": "903-526-7977",
            "fax_number": "903-526-7989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILL J PARKS DDS MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-25",
        "last_updated": "2011-03-25",
        "status": "A",
        "authorized_official_last_name": "PARKS",
        "authorized_official_first_name": "WILL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "903-526-7977",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "17107",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111311002",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jerry D. Wilkerson, P.T.
• Matthew Harry Lee Wilkerson, M.D.
• Jessica Wilkin, M.D.
• Caitlin Nicole Wilkins, ATC, LAT
• Megan Wilkins, CCC-SLP
• Karen Willard, LCDC
• Kimberly Willhite
• William E. Brown, M.D., P.a.
• William Hopson DC PC
• Aaron Williams, M.D.

• Oral and Maxillofacial Surgery (Dentist) in Tyler, TX
• Providers in Tyler, TX by specialty
• Oral and Maxillofacial Surgery (Dentist) in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 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.