KEVIN L PARK (NPI# 1063441491) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063441491 |
| Entity Type | Individual |
| Full Name | KEVIN L PARK |
| Credential | MD |
| Practice Address |
442 W High St Bryan OH 43506-1681 |
| Mailing Address |
3702 New Vision Dr Bldg B Fort Wayne IN 46845-1703 |
| Practice Telephone | 4196364517 |
| Practice Fax Number | 4196366438 |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2019-12-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 35-055915 | OH | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | RAILROAD | 080059933 | 01 |
| OH | 0878386 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013045343 | Kevin Warren Park | Psychiatry & Neurology | 124 River Rd, Kinship Center, Salinas, CA 93908-9601 | 2007-02-28 |
| 1952372914 | Kevin N Park | Psychologist | 5860 S Curtice St, Littleton, CO 80120-1909 | 2006-01-30 |
| 1891308417 | Kevin Park | Pharmacist | 7789 Foothill Blvd, Tujunga, CA 91042-2137 | 2020-08-24 |
| 1619462314 | Kevin Park | Student in an Organized Health Care Education/Training Program | 333 City Blvd W Ste 2150, Orange, CA 92868-5920 | 2018-06-25 |
| 1295102317 | Kevin Park | Dentist | 1365 Barrow St, Abilene, TX 79605-5171 | 2015-08-24 |
| 1649653106 | Kevin Woo Park | Orthopaedic Surgery | 9500 Euclid Ave # A41, Cleveland, OH 44195-0001 | 2015-07-02 |
| 1093103004 | Kevin Park | Pharmacist | 1496 Market St, San Francisco, CA 94102-6004 | 2014-12-26 |
| 1538456710 | Kevin Park | Pharmacist | 12051 Imperial Hwy, Norwalk, CA 90650-3084 | 2011-07-07 |
| 1356579627 | Kevin U Park | Orthopaedic Surgery | 1265 Highway 54 W, Suites 102 and 308, Fayetteville, GA 30214-4548 | 2009-06-25 |
| 1215004965 | Kevin Alan Park | Occupational Therapist | 206b Oxford Rd, New Albany, MS 38652-3115 | 2006-11-29 |
| Street Address |
442 W HIGH ST |
| City | BRYAN |
| State | OH |
| Zip Code | 43506-1681 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669472791 | Sharon A. Ransom | Obstetrics & Gynecology | 442 W High St, Bryan, OH 43506-1681 | 2005-07-29 |
| 1083213714 | Hannah Mckibben | Occupational Therapist | 442 W High St, Bryan, OH 43506-1681 | 2020-10-23 |
| 1992202394 | Jacob Lloyd Nafziger | Family Medicine | 442 W High St, Bryan, OH 43506-1681 | 2018-04-11 |
| 1124524731 | Charity Rose Mott | Nurse Practitioner | 442 W High St, Bryan, OH 43506-1681 | 2018-04-03 |
| 1013410687 | Christine M Barnett | Occupational Therapist | 442 W High St, Bryan, OH 43506-1681 | 2018-03-09 |
| 1609391705 | Erin Jane Copi | Pharmacist | 442 W High St, Bryan, OH 43506 | 2017-08-09 |
| 1326583964 | Kristina Cline | Nurse Practitioner | 442 W High St, Suite 3, Bryan, OH 43506-1681 | 2017-01-05 |
| 1649729872 | Mary Ellen Rittenhouse | Nurse Practitioner | 442 W High St, Bryan, OH 43506-1681 | 2016-09-29 |
| 1073973889 | Anna Trubey | Nurse Practitioner | 442 W High St, Bryan, OH 43506-1681 | 2016-03-07 |
| 1396102273 | Heidi Zuber | Nurse Practitioner | 442 W High St, Bryan, OH 43506-1681 | 2016-01-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750883203 | Jennifer Spangler | Massage Therapist | 228 S. Main St., Bryan, OH 43506 | 2018-03-01 |
| 1922547215 | Alissa Niswonger | Specialist/Technologist | 106 Avenue B, Bryan, OH 43506 | 2017-02-20 |
| 1902140320 | Marcia Jean Slabaugh | Physical Therapy Assistant | 5299 County Road 1575, Bryan, OH 43506 | 2012-11-26 |
| 1215086640 | Filling Memorial Home Cardinal | Intermediate Care Facility, Mentally Retarded | 1211 Cardinal Drive, Bryan, OH 43506 | 2007-01-08 |
| 1396855714 | Williams County Transport | Ambulance | 05842 St Rt 15, Bryan, OH 43506 | 2006-08-30 |
| 1982635603 | Americare Health Services LLC | Durable Medical Equipment & Medical Supplies | 121 E South St, Bryan, OH 43506 | 2006-07-05 |
| 1174561963 | Richard U Baldwin | Emergency Medicine | 433 W. High St., Bryan, OH 43506 | 2006-06-03 |
| 1073595757 | Thomas A. Losey | Family Medicine | 442 West High Street, Midwest Community Health Associates, Bryan, OH 43506 | 2005-11-17 |
| 1841298296 | Claire Laree Osborn | Family Medicine | Activate Healthcare/500 W Mulberry St., Suite 101, Bryan, OH 43506 | 2005-07-11 |
| 1225519762 | Fountain City Chiropractic & Rehabilitation, Inc | Chiropractor | 1525 W High St, Ste A, Bryan, OH 43506 | 2018-08-23 |
| Find all providers in zip 43506 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609333095 | Holly Ann Kleypas | Family Medicine | 1121 Briarcrest Dr Ste 303, Bryan, TX 77802-2500 | 2019-02-21 |
| 1073047437 | Abbi Messer | Family Medicine | 2900 29th Street, Suite 100, Bryan, TX 77802 | 2017-04-12 |
| 1457898660 | Wellspring Physician, P.C. | Family Medicine | 309 N Washington Ave, Suite 13, Bryan, TX 77803-5368 | 2017-01-25 |
| 1700286986 | Michael D. Mckinney, Md. | Family Medicine | 3313 Emory Oak Dr, Bryan, TX 77807-4001 | 2014-08-25 |
| 1437558210 | Wellspring Physician, P.a. | Family Medicine | 309 N. Washington Ave, Suite 13, Bryan, TX 76248 | 2014-08-18 |
| 1639490089 | Kuy Houser | Family Medicine | 2800 S Texas Ave, Suite 202, Bryan, TX 77802-5361 | 2010-06-21 |
| 1275705089 | Michael F. Ruggiero, Do, Pa | Family Medicine | 2901 E 29th St, Suite 123, Bryan, TX 77802-2692 | 2008-04-01 |
| 1750572681 | Benjamin W. Dudycha | Family Medicine | 3351 University Dr E Ste 111, Bryan, TX 77802-3470 | 2007-08-06 |
| 1164634606 | Sybil Jane Taquet | Family Medicine | 2410 Boonville Rd, Bryan, TX 77808-2226 | 2007-05-04 |
| 1831259399 | Davelyn Eaves Hood | Family Medicine | 3370 South Texas Avenue, Suite B, Bryan, TX 77802 | 2006-12-12 |
| Find all providers in BRYAN | ||||
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| 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.