Park, Ih Koo

Park, Ih Koo is an individual health care provider with primary practice located at 100 Gross Crescent Cir , Ft Oglethorpe GA 30742-3643. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Park, Ih Koo can be contacted via phone (706) 861-7275.

Contact Information

Primary practice address
100 Gross Crescent Cir Ft Oglethorpe GA 30742-3643
Phone: (706) 861-7275
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 15885 Georgia
Allopathic & Osteopathic Physicians / Surgery 208600000X 8922 Tennessee

Profile Details

NPI number 1902806227
LBN Legal business name Park, Ih Koo
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 28th, 2005
Last updated Sep 28th, 2012 - 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1902806227 NPPES
Georgia MEDICAID 00062059B

Popular Providers