Provider Demographics
NPI:1588498570
Name:KARA MCELLIGOTT PARK, MD, PLLC
Entity type:Organization
Organization Name:KARA MCELLIGOTT PARK, MD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KARA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCELLIGOTT PARK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:919-260-5553
Mailing Address - Street 1:4415 TALCOTT DR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-6130
Mailing Address - Country:US
Mailing Address - Phone:919-260-5553
Mailing Address - Fax:877-423-3077
Practice Address - Street 1:4415 TALCOTT DR
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-6130
Practice Address - Country:US
Practice Address - Phone:919-260-5553
Practice Address - Fax:877-423-3077
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-30
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty