Fung, Pak K

Fung, Pak K is an individual health care provider with primary practice located at 405 W Jackson St , Carbondale IL 62901-1462. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Fung, Pak K can be contacted via phone (618) 549-0721.

Contact Information

Primary practice address
405 W Jackson St Carbondale IL 62901-1462
Phone: (618) 549-0721
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 036-079290 Illinois

Profile Details

NPI number 1265487870
LBN Legal business name Fung, Pak K
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 23rd, 2006
Last updated Mar 8th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1265487870 NPPES
Illinois MEDICAID 036079290-3
Illinois MEDICAID 036079290-6
Illinois MEDICAID 7100150560
Illinois MEDICAID 036079290
Illinois Other 3932056

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