Male or Other

Dr. Tracy A. Park MD

Physical Medicine & Rehabilitation Physician in Milwaukee, WI(View on Map)

Full Name

Dr. Tracy A Park MD

NPI Number

1194712455

NPI Type

Individual Provider

Gender

Male

Enumeration Date

10/03/2005

Specialties

(Taxonomies)

Licenses

State

Wisconsin
Wisconsin

License Number

30606
30606-020

Contact
Information

Purpose

Mailing
Location

Address

4111 W MITCHELL ST
4111 W MITCHELL ST

City

Milwaukee
Milwaukee

State

WI
WI

Postal Code

53215-1748
53215-1748

Country

US
US

Telephone Number

(414) 385-8800
(414) 385-8800

Identifiers

Identifier

31539700

Identifier State

WI

Identifier Issuer

Unknown

Health Information Exchange

Endpoint Type

DIRECT
FHIR

Endpoint

tpark23228@direct.myadvocateaurora.org
https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Endpoint Description

Unknown
Unknown

Use

Direct
Unknown

Content Type

Unknown
Unknown

Affiliation

N
N

Endpoint Location

4111 W Mitchell StSte 300Milwaukee, WI532151748US
4111 W Mitchell StSte 300Milwaukee, WI532151748US

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 01/26/2023

Provider Address

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Specialty: Physical Medicine & Rehabilitation Physician (Primary)

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Specialty: Physical Medicine & Rehabilitation Physician (Primary)

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