Park, Yong D.

Park, Yong D. is an individual health care provider with primary practice located at 1120 15Th Street , Augusta GA 30912. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology with Special Qualifications in Child Neurology, which is considered as his primary health care specialty. Park, Yong D. can be contacted via phone (706) 721-3371.

Contact Information

Primary practice address
1120 15Th Street Augusta GA 30912
Phone: (706) 721-3371
Fax: (706) 721-3377
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurology with Special Qualifications in Child Neurology 2084N0402X 035114 Georgia

Profile Details

NPI number 1760582712
LBN Legal business name Park, Yong D.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 22nd, 2006
Last updated Mar 31st, 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1760582712 NPPES
Georgia MEDICAID 000473459A
Georgia MEDICAID G07909

Popular Providers