Dr Hyo Kwon Park, DO is a medicare enrolled "Family Medicine" physician in Dinwiddie, Virginia. He went to Philadelphia College Of Osteopathic Medicine and graduated in 2002 and has 23 years of diverse experience with area of expertise as Family Practice. He is a member of the group practice Southern Dominion Health System Inc and his current practice location is
13855 Courthouse Rd, Dinwiddie, Virginia. You can reach out to his office (for appointments etc.) via phone at
(804) 469-3731.
Dr Hyo Kwon Park is licensed to practice in Virginia (license number 0102202692) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1730170770.
Physician's Profile
| Full Name | Dr Hyo Kwon Park |
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| Gender | Male |
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| Speciality | Family Practice |
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| Experience | 23 Years |
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| Location | 13855 Courthouse Rd, Dinwiddie, Virginia |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Hyo Kwon Park attended and graduated from Philadelphia College Of Osteopathic Medicine in 2002
NPI Data:
- NPI Number: 1730170770
- Provider Enumeration Date: 10/31/2005
- Last Update Date: 07/15/2024
Medicare PECOS Information:
- PECOS PAC ID: 7618981622
- Enrollment ID: I20101115000893
Medical Identifiers
Medical identifiers for Dr Hyo Kwon Park such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1730170770 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207Q00000X | Family Medicine | 0102202692 (Virginia) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Southern Dominion Health System Inc | 0648188755 | 17 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Hyo Kwon Park allows following entities to bill medicare on his behalf.
| Entity Name | Southern Dominion Health System Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1295706588
PECOS PAC ID: 0648188755
Enrollment ID: O20040611000631 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Hyo Kwon Park is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Dr Hyo Kwon Park, DO
P.o. Box 70, 1508 K-v Road,
Victoria, VA 23974
Ph: (434) 696-2165 | Dr Hyo Kwon Park, DO
13855 Courthouse Rd,
Dinwiddie, VA 23841-2254
Ph: (804) 469-3731 |
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