Christopher Lane Park, DO | |
11 E Jefferson St, Pontotoc, MS 38863-2807 | |
(662) 499-2802 | |
(866) 939-1560 |
Full Name | Christopher Lane Park |
---|---|
Gender | Male |
Speciality | Family Practice |
Experience | 19 Years |
Location | 11 E Jefferson St, Pontotoc, Mississippi |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1710181078 | NPI | - | NPPES |
06575065 | Medicaid | MS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 19482 (Mississippi) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Kindred At Home | Tupelo, MS | Home health agency |
North Mississippi Medical Ctr Hha | Tupelo, MS | Home health agency |
Baptist Memorial Hospital Union County | New albany, MS | Hospital |
Pontotoc Health Service Inc Cah | Pontotoc, MS | Hospital |
North Mississippi Medical Center | Tupelo, MS | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Chris Park Do Pc | 6204258064 | 3 |
Entity Name | Redmed, Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1437589157 PECOS PAC ID: 2961633656 Enrollment ID: O20140321001095 |
Entity Name | Chris Park Do Pc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1831710623 PECOS PAC ID: 6204258064 Enrollment ID: O20200624001003 |
Mailing Address | Practice Location Address |
---|---|
Christopher Lane Park, DO 542 Cedar Hill Dr, Pontotoc, MS 38863-7262 Ph: (662) 397-4597 | Christopher Lane Park, DO 11 E Jefferson St, Pontotoc, MS 38863-2807 Ph: (662) 499-2802 |
Steven Nicholas Dirmeyer, M.D. Family Medicine Medicare: Medicare Enrolled Practice Location: 345 Highway 15 N, Pontotoc, MS 38863 Phone: 662-489-7430 Fax: 662-489-7938 | |
Timothy Frank Thompson, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 353 Highway 15 N, Pontotoc, MS 38863 Phone: 662-490-1985 Fax: 662-490-1989 | |
Dr. Jennifer Dawn Lowery, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 345 Highway 15 N, Pontotoc, MS 38863 Phone: 662-489-7430 | |
Mrs. Flavia H West, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 183 S Main St, Pontotoc, MS 38863 Phone: 662-489-5038 Fax: 662-489-7004 | |
Stephen Montgomery, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 345 Highway 15 N, Pontotoc, MS 38863 Phone: 662-489-7430 Fax: 662-489-7938 | |
Randel Gibson, DO Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 353 Highway 15 N, Pontotoc, MS 38863 Phone: 662-490-1985 Fax: 662-490-1989 |