| Eugene L Park, MD | |
|
40 Medical Park Blvd Ste D, Petersburg, VA 23805 | |
| (804) 765-6100 | |
| (804) 765-6101 |
| Full Name | Eugene L Park |
|---|---|
| Gender | Male |
| Speciality | Urology |
| Experience | 28 Years |
| Location | 40 Medical Park Blvd Ste D, Petersburg, Virginia |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992707137 | NPI | - | NPPES |
| 1992707137 | Medicaid | VA | |
| 860777 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208800000X | Urology | 0101247088 (Virginia) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Southside Regional Medical Center | Petersburg, VA | Hospital |
| Bon Secours St Marys Hospital | Richmond, VA | Hospital |
| Bon Secours St Francis Medical Center | Midlothian, VA | Hospital |
| Southern Virginia Regional Medical Center | Emporia, VA | Hospital |
| Bon Secours Memorial Regional Medical Center | Mechanicsville, VA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Bon Secours Medical Group Richmond Specialty Care Llc | 8022440056 | 355 |
| Entity Name | Bon Secours Medical Group Richmond Specialty Care Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1477112225 PECOS PAC ID: 8022440056 Enrollment ID: O20191113002170 |
| Mailing Address | Practice Location Address |
|---|---|
| Eugene L Park, MD 8580 Magellan Pkwy, Richmond, VA 23227-1149 Ph: (804) 765-6100 | Eugene L Park, MD 40 Medical Park Blvd Ste D, Petersburg, VA 23805 Ph: (804) 765-6100 |
William Roger Visser, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 40 Medical Park Blvd Ste D, Petersburg, VA 23805 Phone: 804-765-6100 Fax: 804-765-5373 |