Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
IH KOO PARK, MD
ActiveIH KOO PARK, MD is a General Surgery healthcare provider located in FT OGLETHORPE, Georgia. NPI 1902806227 is currently active in the NPPES registry. Verify at CMS.
General Surgery · FT OGLETHORPE, GA
Registration Details
- NPI Number
- 1902806227
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jul 28, 2005 (21.085120424757 yrs)
- Last Updated
- Sep 28, 2012
- Licenses
-
15885 (GA)8922 (TN)
Practice Information
- Address
-
100 GROSS CRESCENT CIRFT OGLETHORPE, GA, 307423643Browse GA providers · Browse ZIP 30742
- Phone
- 7068617275
- Primary Specialty
-
General Surgery
208600000X
- Additional Specialty
- General Surgery
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.