Mr Jung Tae Park, MD is a medicare enrolled "Family Medicine - Adult Medicine" physician in Whitwell, Tennessee. He graduated from medical school in 1966 and has 58 years of diverse experience with area of expertise as General Practice. He is a member of the group practice Park Medical and his current practice location is
13851 Highway 28, Whitwell, Tennessee. You can reach out to his office (for appointments etc.) via phone at
(423) 658-9200.
Mr Jung Tae Park is licensed to practice in Tennessee (license number MD0000010100) 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 1942291638.
Physician's Profile
| Full Name | Mr Jung Tae Park |
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| Gender | Male |
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| Speciality | General Practice |
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| Experience | 58 Years |
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| Location | 13851 Highway 28, Whitwell, Tennessee |
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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:
- Mr Jung Tae Park graduated from medical school in 1966
NPI Data:
- NPI Number: 1942291638
- Provider Enumeration Date: 11/02/2005
- Last Update Date: 12/14/2022
Medicare PECOS Information:
- PECOS PAC ID: 9739136839
- Enrollment ID: I20050331000900
Medical Identifiers
Medical identifiers for Mr Jung Tae Park such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1942291638 | NPI | - | NPPES |
| 2002139 | Other | TN | B CARE |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207QA0505X | Family Medicine - Adult Medicine | MD0000010100 (Tennessee) | Primary |
Medical Facilities Affiliation
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. Mr Jung Tae Park allows following entities to bill medicare on his behalf.
| Entity Name | Park Medical |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1124737408
PECOS PAC ID: 1456721224
Enrollment ID: O20230112001648 |
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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. Mr Jung Tae 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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Mr Jung Tae Park, MD
Po Box 400, 13851 Highway 28,
Whitwell, TN 37397-0400
Ph: (423) 658-9200 | Mr Jung Tae Park, MD
13851 Highway 28,
Whitwell, TN 37397-5373
Ph: (423) 658-9200 |
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