Provider Demographics
NPI:1144269671
Name:PARKS, CHRIS (CRNA)
Entity type:Individual
Prefix:
First Name:CHRIS
Middle Name:
Last Name:PARKS
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6300 NW EXPRESSWAY STE 120
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73132-5128
Mailing Address - Country:US
Mailing Address - Phone:405-445-3697
Mailing Address - Fax:405-212-5571
Practice Address - Street 1:6300 NW EXPRESSWAY STE 120
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73132-5128
Practice Address - Country:US
Practice Address - Phone:405-445-3697
Practice Address - Fax:405-212-5571
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-06
Last Update Date:2020-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR2029229207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100783990BMedicaid