Park, Jason
Park, Jason is an individual health care provider with primary practice located at 105 W Stone Dr Ste 4B, Kingsport TN 37660-3256. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Park, Jason can be contacted via phone (423) 578-1570.Contact Information
Primary practice address
105 W Stone Dr Ste 4B
Kingsport TN 37660-3256
Phone: (423) 578-1570
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | 42228 | Tennessee |
Profile Details
| NPI number | 1457554826 |
|---|---|
| LBN Legal business name | Park, Jason |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 6th, 2007 |
| Last updated | Sep 23rd, 2009 - about 16 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1457554826 | NPPES |
| Tennessee | MEDICAID | 3000606 |
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