Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. JUNG TAE PARK, MD
Active Sole ProprietorMR. JUNG TAE PARK, MD is a Adolescent Medicine healthcare provider located in WHITWELL, Tennessee. NPI 1942291638 is currently active in the NPPES registry. Verify at CMS.
Adolescent Medicine · WHITWELL, TN
Registration Details
- NPI Number
- 1942291638
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Nov 2, 2005 (20.791386958046 yrs)
- Last Updated
- Dec 14, 2022
- License
-
MD0000010100 (TN)
- Sole Proprietor
- Yes
Practice Information
- Address
-
13851 HIGHWAY 28WHITWELL, TN, 373975373Browse TN providers · Browse ZIP 37397
- Phone
- 4236589200
- Fax
- 4236582195
- Primary Specialty
-
Adolescent Medicine
207QA0505X
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.