Dr Kathryn L Park, MD is a
Pain Medicine - Pain Medicine physician based in Mishawaka, Indiana. Dr Kathryn L Park is licensed to practice in Indiana (license number 01055115A) and her current practice location is 301 E Day Rd, Mishawaka, Indiana. She can be reached at her office (for appointments etc.) via phone at
(574) 237-9340.
NPI number for Dr Kathryn L Park is 1548250186 and her current mailing address is 301 E Day Rd, Mishawaka, Indiana. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1548250186.
Physician's Profile
| Full Name | Dr Kathryn L Park |
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| Gender | Female |
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| Speciality | Pain Medicine - Pain Medicine |
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| Location | 301 E Day Rd, Mishawaka, Indiana |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1548250186
- Provider Enumeration Date: 10/25/2005
- Last Update Date: 11/04/2019
Medical Identifiers
Medical identifiers for Dr Kathryn L Park such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1548250186 | NPI | - | NPPES |
| 200349420 | Medicaid | IN | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 208100000X | Physical Medicine & Rehabilitation | 01055115A (Indiana) | Secondary |
| 208VP0000X | Pain Medicine - Pain Medicine | 01055115A (Indiana) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Kathryn L Park is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Kathryn L Park, MD
301 E Day Rd,
Mishawaka, IN 46545-3455
Ph: (574) 237-9340 | Dr Kathryn L Park, MD
301 E Day Rd,
Mishawaka, IN 46545-3455
Ph: (574) 237-9340 |
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