| Jung Tae Park | |
|
13851 Highway 28 Whitwell TN 37397-5373 | |
| (423) 658-9200 | |
| (423) 658-2195 |
| Full Name | Jung Tae Park |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 13851 Highway 28, Whitwell, Tennessee |
| Authorized Official Name and Position | Jung Tae Park (MD-OWNER) |
| Authorized Official Contact | 4236589200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jung Tae Park 13851 Highway 28 Po Box 400 Whitwell TN 37397-5373 Ph: (423) 658-9200 | Jung Tae Park 13851 Highway 28 Whitwell TN 37397-5373 Ph: (423) 658-9200 |
| NPI Number | 1225409147 |
|---|---|
| Provider Enumeration Date | 10/19/2015 |
| Last Update Date | 11/01/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225409147 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
Brenda Ross Md Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 13851 Highway 28, Whitwell, TN 37397 Phone: 423-658-9200 Fax: 423-658-2195 | |
Park Medical Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 13851 Highway 28, Whitwell, TN 37397 Phone: 423-658-9200 Fax: 423-658-2195 |