Park, Jong

Park, Jong is an individual health care provider with primary practice located at 3215 N Northhills Blvd , Fayetteville AR 72703-4424. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Park, Jong can be contacted via phone (479) 968-7930.

Contact Information

Primary practice address
3215 N Northhills Blvd Fayetteville AR 72703-4424
Phone: (479) 968-7930
Fax: (479) 968-4331
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X E5013 Arkansas

Profile Details

NPI number 1952526972
LBN Legal business name Park, Jong
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 16th, 2007
Last updated Jun 10th, 2010 - about 14 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 1952526972 NPPES
Arkansas Other 5H161 BCBS
Arkansas MEDICAID 175747001 BCBS

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