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Dr. George S Park, PHD,MP
Prescribing (Medical) Psychologist in Bossier City, Louisiana
NPI 1437199031

George S Park is a Prescribing (Medical) Psychologist based in Bossier City, LA and is specialized in Prescribing (Medical). George S Park practices in Bossier City, LA and has the professional credentials of PHD,MP. The NPI Number for George S Park is 1437199031 and holds a License No. MP0983 (Louisiana).

The current practice location address for George S Park is 2285 Benton Rd Bldg 3, Bossier City, LA and can be reached out via phone at 318-415-8755 and via fax at 318-746-8565.

Location: 2285 Benton Rd Bldg 3, Bossier City, LA, 71171-5478
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1437199031
Provider Name
George S Park
Credential
PHD,MP
Provider Entity Type
Individual
Gender
Male
Address
2285 Benton Rd Bldg 3, Bossier City, LA, 71171-5478
Phone Number
318-415-8755
Fax Number
318-746-8565
Provider Enumeration Date
06/08/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
314936 01 LA MEDICARE PTAN
institution
Provider Business Practice Location Address Details
Address
2285 Benton Rd Bldg 3
City
Bossier City
State
Louisiana
Zip
71111-7933
Phone Number
318-415-8755
Fax Number
318-746-8565
person
Provider Business Mailing Address Details
Address
2285 Benton Rd Bldg 3
City
Bossier City
State
Louisiana
Zip
71111-7933
Phone Number
318-415-8755
Fax Number
318-746-8565
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Psychologist
Speciality
Prescribing (Medical)
Taxonomy
103TP0016X
License No.
MP0983 (Louisiana)
Definition
A licensed, doctoral-level psychologist authorized to prescribe and has undergone specialized education and training in preparation for prescriptive practice and has passed an examination accepted by the state board of psychology relevant to establishing competence for prescribing, and has received from the state board of psychology a current certificate granting prescriptive authority, which has not been revoked or suspended.
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