person
Heather Pennell Park, MD
Vascular Surgery Physician in Carrollton, Georgia
NPI 1851510119

Heather Pennell Park is a Vascular Surgery Physician based in Carrollton, GA and is specialized in Vascular Surgery. Heather Pennell Park practices in Carrollton, GA and has the professional credentials of MD. The NPI Number for Heather Pennell Park is 1851510119 and holds a License No. 67715 (Georgia).

The current practice location address for Heather Pennell Park is 157 Clinic Ave, Carrollton, GA and can be reached out via phone at 770-812-5902 and via fax at 770-812-5903.

Location: 157 Clinic Ave, Carrollton, GA, 30117-3857
person
Provider Profile Details
NPI Number
1851510119
Provider Name
Heather Pennell Park
Credential
MD
Provider Entity Type
Individual
Gender
Female
Address
157 Clinic Ave, Carrollton, GA, 30117-3857
Phone Number
770-812-5902
Fax Number
770-812-5903
Provider Enumeration Date
04/25/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
003124240A 05 GA
institution
Provider Business Practice Location Address Details
Address
157 Clinic Ave
City
State
Zip
30117-4454
Phone Number
770-812-5902
Fax Number
770-812-5903
person
Provider Business Mailing Address Details
Address
157 Clinic Ave
City
State
Zip
30117-4454
Phone Number
770-812-5902
Fax Number
770-812-5903
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Surgery
Speciality
Vascular Surgery
Taxonomy
License No.
67715 (Georgia)
Definition
A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.
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