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Contact Information

BERT E PARK, MD
1515 W TRUMAN RD
SUITE 607
INDEPENDENCE, MO64050-3436
 Phone: 816-833-0466
 Fax: 816-833-4155
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Neurological Surgery

207T00000X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for BERT E PARK · (Male)

NPI Number 1407841851
Status Active
Credentials MD
Entity Individual
Enumeration date 09/13/2005
Last updated 08/14/2007 - About 19 years ago
Sole proprietor 1 No
Identifiers
  • MO License # R7A63
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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