Frederic C Park III, MD
Radiology, Diagnostic Radiology in Cape Girardeau, MO. Individual provider (NPI-1).
NPI number1821189002
StatusActive
Last updated in NPPESAug 2, 2022
Details
- NPI
- 1821189002
- Entity type
- Individual (NPI-1)
- Name
- Frederic C Park III
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Sep 27, 2006
- Certification date
- Aug 2, 2022
- Last updated
- Aug 2, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2085R0202X | Radiology, Diagnostic Radiology | 21342 | KY | Yes |
Practice location
70 Doctors ParkCape Girardeau, MO 63703-4928
Phone 573-334-6071 · Fax 812-471-6650
Mailing address
70 Doctors ParkCape Girardeau, MO 63703-4928
Phone 573-334-6071 · Fax 812-471-6650
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