THE PARK CLINIC FOR COSMETIC AND RECONSTRUCTIVE SURGERY, P.C. (NPI# 1821246869) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821246869 |
| Entity Type | Organization |
| Organization Name | THE PARK CLINIC FOR COSMETIC AND RECONSTRUCTIVE SURGERY, P.C. |
| Practice Address |
3153 Dauphin St Mobile AL 36606-4061 |
| Mailing Address |
Po Box 852047 Mobile AL 36685-2047 |
| Practice Telephone | 2513406600 |
| Mailing Telephone | 2513406600 |
| Enumeration Date | 2008-09-03 |
| Last Update Date | 2009-03-18 |
| Authorized Official Name | CHRISTOPHER A PARK (PRESIDENT) |
| Authorized Official Telephone | 2513406600 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | Y |
| Parent Organization Name | MOBILE PLASTIC AND RECONSTRUCTIVE SURGERY AND DERMATOLOGY |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
MD.28938 | AL | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AL | MEDICARE PTAN | 510G700432 | 01 |
| AL | RAILROAD MEDICARE PTAN | 510G700432 | 01 |
| AL | BLUE CROSS BLUE SHIELD AL | 51595045 | 01 |
| Street Address |
3153 DAUPHIN ST |
| City | MOBILE |
| State | AL |
| Zip Code | 36606-4061 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700826443 | Roberta G Swain | Dermatology | 3153 Dauphin St, Mobile, AL 36606-4061 | 2006-06-08 |
| 1730644824 | Megan Vallance Mcneil | Nurse Practitioner | 3153 Dauphin St, Mobile, AL 36606-4061 | 2019-02-04 |
| 1508203456 | Ryan Edward Rebowe | Plastic Surgery | 3153 Dauphin St, Mobile, AL 36606-4061 | 2013-06-02 |
| 1770734154 | Dermatology and Dermatology Surgery of Mobile PC | Dermatology | 3153 Dauphin St, Mobile, AL 36606-4061 | 2008-10-03 |
| 1497885339 | Christopher A Park | Plastic Surgery | 3153 Dauphin St, Mobile, AL 36606-4061 | 2007-03-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982216388 | Kaitlyn Culotta Dozier | Student in an Organized Health Care Education/Training Program | 936 Grant Park Drive, Mobile, AL 36606 | 2020-08-18 |
| 1902466758 | Gulf Coast Totalcare | Case Management | 3280 Dauphin Street, Building C, Suite 1, Mobile, AL 36606 | 2019-06-14 |
| 1023581246 | Elizabeth Fair | Psychologist | 3168 Midtown Park S Ste E, Mobile, AL 36606 | 2019-01-10 |
| 1962987420 | Asra Bashir | Pharmacist | 101 East Interstate 65 Service Rd S, Mobile, AL 36606 | 2018-10-01 |
| 1902398274 | Tunisia London | Social Worker | 601 Bel Air Blvd Ste 411, Mobile, AL 36606 | 2018-06-03 |
| 1962925677 | Tasheka Janine Scott I | Nurse's Aide | 629 Crenshaw Street, Mobile, AL 36606 | 2017-07-25 |
| 1295128189 | Costco Wholesale Corporation | Eyewear Supplier (Equipment, not the service) | 1450 Tingle Circle West, Mobile, AL 36606 | 2015-03-17 |
| 1437441623 | Julia Marco Williams | Counselor | 605 Bel Air Blvd Ste 33, Mobile, AL 36606 | 2011-05-06 |
| 1235363516 | Jenny M Neese | Dietitian, Registered | 2504 Dauphin Street, Suite J, Mobile, AL 36606 | 2009-05-14 |
| 1609000223 | Bay Area Nutrition, Inc | Dietitian, Registered | 2029-b Airport Blvd, Suite 195, Mobile, AL 36606 | 2009-05-11 |
| Find all providers in zip 36606 | ||||
| Taxonomy Code | 261QM2500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Medical Specialty |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922629898 | Snatchednspirit LLC | Clinic/Center | 3993 Cottage Hill Rd Apt 19c3993, Mobile, AL 36609-8418 | 2020-05-02 |
| 1972764405 | Oscar D Almeida Jr Md PC | Clinic/Center | 176 Mobile Infirmary Blvd, Mobile, AL 36607-3510 | 2008-06-18 |
| 1841566627 | Mobile Cancer Center, Inc | Clinic/Center | 3719 Dauphin St, Suite 100, Mobile, AL 36608-1753 | 2012-03-27 |
| 1427349919 | Mobility Metabolism & Wellness P C | Clinic/Center | 4357 Midmost Dr, Mobile, AL 36609-5505 | 2011-05-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003430109 | Alamed Neurology, Inc | Clinic/Center | 7070 Aaron Aronov Dr Ste K, Fairfield, AL 35064-1809 | 2020-06-04 |
| 1508403031 | Veyep | Clinic/Center | 2100 Devereux Cir Ste 201, Vestavia, AL 35243-2562 | 2019-12-03 |
| 1215591243 | Alamed Injury Clinics | Clinic/Center | 7070 Aaron Aronov Dr Ste M, Fairfield, AL 35064-1809 | 2019-04-25 |
| 1114581147 | Alamed Surgical Centers | Clinic/Center | 7070 Aaron Aronov Dr Ste O, Fairfield, AL 35064-1809 | 2019-04-25 |
| 1215428529 | Ob-gyn Associates of Anniston LLC | Clinic/Center | 901 Leighton Ave Ste 102, Anniston, AL 36207-5703 | 2018-05-22 |
| 1154833689 | Monica Handy Crawford, Md, LLC | Clinic/Center | 801 Noble St Ste 1022, Anniston, AL 36201-5698 | 2017-10-24 |
| 1538619465 | Intrinsic Balance Chiropractic and Health Services | Clinic/Center | 3760 Highway 53, Ste L, Huntsville, AL 35806-4726 | 2016-10-04 |
| 1942668397 | Jerry Dillard Md | Clinic/Center | 206 W Dallas Ave, Selma, AL 36701-6531 | 2016-01-31 |
| 1346660487 | Dr Doctor Disc Injury and Spinal Care Clinic PC | Clinic/Center | 1117 7th Ave W, Birmingham, AL 35204-3408 | 2014-04-16 |
| 1366794208 | The Adult Medical Specialist, PC | Clinic/Center | 81 Market Pl, Montgomery, AL 36117-4908 | 2012-10-02 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on THE PARK CLINIC FOR COSMETIC AND RECONSTRUCTIVE SURGERY, P.C..
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.