BETHANY LYNN PARK PA-C
NPI 1114781747
Physician Assistant in Southfield, MI

Active since February 13, 2024
27177 LAHSER RD, SOUTHFIELD, MI 48034(989) 277-6478 Get Directions Write a Review

NPPES record last updated: February 13, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Bethany Lynn Park Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BETHANY LYNN PARK PA-C (NPI 1114781747) is an individual physician assistant in Southfield, Michigan, licensed in Michigan (5601012241) and active in the NPI registry since February 2024.

NPPES Registry Identity

NPI1114781747
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameBETHANY LYNN PARKCredential: PA-C
Location Address27177 LAHSER RDSouthfield, MI 48034-4714
Mailing Address1521 Royal Oak St SwWyoming, MI 49509-2711 · (989) 277-6478
Sole ProprietorYes
Enumeration DateFebruary 13, 2024
NPPES CertifiedFebruary 13, 2024
NPI 1114781747 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License Licensed in MI · 5601012241
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
27177 LAHSER RD, Southfield, MI 48034

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Specialist
27177 LAHSER RD, SUITE103
SOUTHFIELD, MI 48034
Surgery
27177 LAHSER RD, SUITE NUMBER 104
SOUTHFIELD, MI 48034
Specialist
27177 LAHSER RD, SUITE 103
SOUTHFIELD, MI 48034
Pharmacy (Community/Retail Pharmacy)
27177 LAHSER RD, SUITE 102
SOUTHFIELD, MI 48034
Internal Medicine
27177 LAHSER RD, SUITE 104
SOUTHFIELD, MI 48034
Audiologist
27177 LAHSER RD, SUITE 203
SOUTHFIELD, MI 48034
Obstetrics & Gynecology
27177 LAHSER RD, STE 100
SOUTHFIELD, MI 48034
Specialist
27177 LAHSER RD, SUITE 104
SOUTHFIELD, MI 48034

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bethany Park's NPI number?

The NPI number for Bethany Park is 1114781747. It was assigned to this individual provider in the NPPES registry on February 13, 2024.

Where is Bethany Park located?

Bethany Park practices at 27177 Lahser Rd, Southfield, MI 48034. The listed phone number is (989) 277-6478.

What is Bethany Park's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

When was this NPI record last updated?

The NPPES record for Bethany Park was last updated on February 13, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.