Kevin W Parks (NPI# 1467499475, PAC ID# 8022072511) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is ALLERGY/IMMUNOLOGY.
| Nation Provider ID (NPI) | 1467499475 |
| PAC ID by PECOS | 8022072511 |
| Professional Enrollment ID | I20070503000169 |
| Full Name | Kevin W Parks |
| Organization Legal Name | ALLERGY AND ASTHMA CENTER OF SOUTHERN ORGEON, PC |
| Address |
3860 Crater Lake Ave Medford OR 97504-9741 |
| Phone Number | 5418581003 |
| Gender | M |
| Credential | MD |
| Medical School | UNIVERSITY OF CALIFORNIA, SAN DIEGO SCHOOL OF MEDICINE |
| Graduation Year | 2001 |
| Primary Specialty | ALLERGY/IMMUNOLOGY |
| Group Practice PAC ID | 1355449141 |
| Number of Group Practice Members | 5 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 380018 | ASANTE ROGUE REGIONAL MEDICAL CENTER |
| 380002 | ASANTE THREE RIVERS MEDICAL CENTER |
| 380027 | MERCY MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 869 Ne 7th St, Grants Pass, OR 97526-1634 | 5418581003 | ALLERGY AND ASTHMA CENTER OF SOUTHERN ORGEON, PC |
| 2628 Clover St, Klamath Falls, OR 97601-1132 | 5418581003 | ALLERGY AND ASTHMA CENTER OF SOUTHERN ORGEON, PC |
| 3860 Crater Lake Ave, Medford, OR 97504-9741 | 5418581003 | ALLERGY AND ASTHMA CENTER OF SOUTHERN ORGEON, PC |
| Organization Legal Name | ALLERGY AND ASTHMA CENTER OF SOUTHERN ORGEON, PC |
| Physicians | 5 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kary Anne Kelly | Nurse Practitioner | Allergy and Asthma Center of Southern Orgeon, PC | 3860 Crater Lake Ave, Medford, OR 97504-9741 |
| Ryan B Israelsen | Allergy/immunology | Allergy and Asthma Center of Southern Orgeon, PC | 3860 Crater Lake Ave, Medford, OR 97504-9741 |
| Edward M Kerwin | Allergy/immunology | Allergy and Asthma Center of Southern Orgeon, PC | 3860 Crater Lake Ave, Medford, OR 97504-9741 |
| Jaleh K Ostovar | Nurse Practitioner | Allergy and Asthma Center of Southern Orgeon, PC | 3860 Crater Lake Ave, Medford, OR 97504-9741 |
| Street Address |
3860 CRATER LAKE AVE |
| City | MEDFORD |
| State | OR |
| Zip | 97504-9741 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kary Anne Kelly | Nurse Practitioner | Allergy and Asthma Center of Southern Orgeon, PC | 3860 Crater Lake Ave, Medford, OR 97504-9741 |
| Ryan B Israelsen | Allergy/immunology | Allergy and Asthma Center of Southern Orgeon, PC | 3860 Crater Lake Ave, Medford, OR 97504-9741 |
| Edward M Kerwin | Allergy/immunology | Allergy and Asthma Center of Southern Orgeon, PC | 3860 Crater Lake Ave, Medford, OR 97504-9741 |
| Jaleh K Ostovar | Nurse Practitioner | Allergy and Asthma Center of Southern Orgeon, PC | 3860 Crater Lake Ave, Medford, OR 97504-9741 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kimberly Anne Zaslow | Family Medicine | Providence Health and Services Oregon | 70 Bower Dr, Medford, OR 97504 |
| Benjamin Robert Oldson | Family Medicine | Providence Health and Services Oregon | 70 Bower Dr, Medford, OR 97504 |
| Shirley A Malcolm | Osteopathic Manipulative Medicine | Providence Health and Services Oregon | 70 Bower Dr, Medford, OR 97504 |
| Denise M Viss | Nurse Practitioner | Providence Health and Services Oregon | 70 Bower Dr, Medford, OR 97504 |
| Carissa D Scalf | Psychologist, Clinical | Providence Health and Services Oregon | 70 Bower Dr, Medford, OR 97504 |
| Wesley T Ramoso | Family Medicine | Providence Health and Services Oregon | 70 Bower Dr, Medford, OR 97504 |
| Uzomechine Thabiso Chiedozi | Family Medicine | Providence Health and Services Oregon | 70 Bower Dr, Medford, OR 97504 |
| Grant A Jolliffe | Nurse Practitioner | Providence Health and Services Oregon | 70 Bower Dr, Medford, OR 97504 |
| Travis Adam Day | Nurse Practitioner | Providence Health and Services Oregon | 70 Bower Dr, Medford, OR 97504 |
| Jasmin Williams | Clinical Social Worker | Options for Southern Oregon | 1700 E Barnett Rd, Medford, OR 97504-0052 |
| Find all physicians in zip 97504 | |||
| City | MEDFORD |
| Zip Code | 97504 |
| Specialty | ALLERGY/IMMUNOLOGY |
| City + Specialty | MEDFORD + ALLERGY/IMMUNOLOGY |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.