Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Julie Park, MD

Individual provider Pediatrics Physician · NPI 1568916625

Julie Park, MD is a Pediatric Medicine in Columbia, Missouri. Qualified in 2015, 11 years ago. Practices with Legacy Clinics LLC, a 718-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Missouri and Oregon.

Years since qualifying
11
Licensed in
MO, OR
In the registry since
2016
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

404 N Keene St Women's And Children's Hospital
Columbia, MO 65201-6626
Phone: (573) 882-4438
Fax: (573) 884-9992
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 501 N Graham St Ste 375, Portland, OR 97227-2001 — (503) 413-1600

Specialties & licences

Pediatric Endocrinology Physician (primary) Taxonomy 2080P0205X · Licence MD197784 (OR)
Pediatrics Physician Taxonomy 208000000X · Licence 2016022755 (MO)

Record details

NPI number1568916625
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorYes
NPI enumeratedAugust 6, 2016
Last updated in NPPESAugust 22, 2024
Certification dateAugust 22, 2024
Mailing address400 N Keene St, South Pavilion, Columbia, MO 65201-6626

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPEDIATRIC MEDICINE
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice Legacy Clinics Llc — 718 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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