KWANG-SOO PARK


Address: 6915 Tutt Blvd Ste 110b, Colorado Springs, CO 80923
Phone: 7194451292

KWANG-SOO PARK (NPI# 1689635880) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1689635880
Entity Type Individual
Full Name KWANG-SOO PARK
Credential MD
Practice Address 6915 Tutt Blvd Ste 110b
Colorado Springs
CO 80923
Mailing Address 1065 Ne 125th St Ste 409
North Miami
FL 33161-5834
Practice Telephone 7194451292
Practice Fax Number 7195916486
Mailing Telephone 8888526672
Mailing Fax Number 8777200502
Enumeration Date 2006-03-29
Last Update Date 2018-07-30
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2084P0800X Psychiatry & Neurology
Specialization: Psychiatry
0060675 CO Allopathic & Osteopathic Physicians
N 2084P0805X Psychiatry & Neurology
Specialization: Geriatric Psychiatry
DR0060675 CO Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
WV 1840930000 05
OH 2334978 05

Office Location

Street Address 6915 TUTT BLVD STE 110B
City COLORADO SPRINGS
State CO
Zip Code 80923

Providers in the same location

NPI Name Taxonomy Address Enumeration
1366439770 Michael Salvatore Dugo Family Medicine 6915 Tutt Blvd Ste 110b, Colorado Springs, CO 80923-3591 2005-09-30
1750908539 Compass Colorado Healthcare Systems, Inc. Counselor 6915 Tutt Blvd Ste 110b, Colorado Springs, CO 80923-3591 2020-06-29
1285277038 Michael Gordon Herriott Psychiatry & Neurology 6915 Tutt Blvd Ste 110b, Colorado Springs, CO 80923-3591 2019-10-24
1659928562 Tina M Nance Registered Nurse 6915 Tutt Blvd Ste 110b, Colorado Springs, CO 80923-3591 2019-08-26
1194386714 Victoria Mae Rachel Mikolajczyk Social Worker 6915 Tutt Blvd Ste 110b, Colorado Springs, CO 80923-3591 2019-06-25
1902322852 Sheri Nielsen Rockwood Nurse Practitioner 6915 Tutt Blvd Ste 110b, Colorado Springs, CO 80923-3591 2017-08-22
1528580487 Joelle Josephina Bailey Registered Nurse 6915 Tutt Blvd Ste 110b, Colorado Springs, CO 80923-3591 2017-07-12
1245698661 Valerie Ann Kehl Nurse Practitioner 6915 Tutt Blvd Ste 110b, Colorado Springs, CO 80923-3591 2016-01-29
1316312267 Jason Michael Seed Nurse Practitioner 6915 Tutt Blvd Ste 110b, Colorado Springs, CO 80923-3591 2015-12-03
1477923407 Tzu Hui Lee Registered Nurse 6915 Tutt Blvd Ste 110b, Colorado Springs, CO 80923-3591 2015-10-02
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1356942171 Colorado Otolaryngology Associates, LLC Specialist 6031 E. Woodmen Rd., Ste. 300, Colorado Springs, CO 80923 2020-11-06
1750993861 Kara Pitou Dietitian, Registered 7064 Renegade Ridge Dr, Colorado Springs, CO 80923 2020-08-19
1366933632 The Traveling Therapist, LLC Social Worker 6319 Sundance Kid Dr, Colorado Springs, CO 80923 2018-05-22
1669972246 Stacy H Furukawa Behavior Technician 5719 Hawk Springs Dr, Colorado Springs, CO 80923 2018-02-20
1528573854 Wal-mart Sores, Inc. Durable Medical Equipment & Medical Supplies 7825 Dublin Blvd, Colorado Springs, CO 80923 2017-12-08
1699148544 Kristin Sekelsky Nurse Practitioner 6160 Tutt Blvd Ste 150, Colorado Springs, CO 80923 2015-11-01
1164826640 Nancy Bakhtiar Massage Therapist 6160 Tutt Blve #102, Colorado Springs, CO 80923 2014-10-13
1558664326 Helen Sobeck Nurse Practitioner 6001 E. Woodmen Road, Nicu St. Frances Medical Center, Colorado Springs, CO 80923 2010-12-16
1679891832 Tristan Poe Lindberg Pediatrics 6001 E Woodmen Road, Colorado Springs, CO 80923 2010-05-12
1194058933 Tiffany Ann Nelson Physician Assistant 6001 E. Woodmen Rd., St. Francis Medical Center - Nicu, Colorado Springs, CO 80923 2009-09-11
Find all providers in zip 80923

Taxonomy Information

Taxonomy Code 2084P0800X
Grouping Allopathic & Osteopathic Physicians
Classification Psychiatry & Neurology
Specialization Psychiatry

Taxonomy Definition

A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.
Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1417181751 Kevin N Batterbee D.o. LLC Psychiatry & Neurology 13255 Honey Run Way, Colorado Springs, CO 80921-2087 2009-05-14
1215196696 Deane Shore Berson Psychiatry & Neurology 1424 North Hancock Avenue 3 West, Deane Shore Berson Md, Colorado Springs, CO 80903 2008-06-02
1043477649 Rhonda Nicole Sims Psychiatry & Neurology 6915 Tutt Boulevard, Suite 110b, Colorado Springs, CO 80923-3591 2008-05-21
1699963280 Kurt Peters Psychiatry & Neurology 90 S Cascade Ave Ste 810, Colorado Springs, CO 80903-1675 2007-10-09
1184750408 Thomas P Kittelsen Psychiatry & Neurology 7680 Goddard St Ste 120, Colorado Springs, CO 80920-8233 2007-02-23
1831237098 Ardis Capprice Martin Psychiatry & Neurology 4740 Flintridge Dr, Suite 214, Colorado Springs, CO 80918-4253 2007-02-01
1700938289 Scott Helm Mcclure Psychiatry & Neurology 90 S Cascade Ave, Suite 810, Colorado Springs, CO 80903 2007-01-17
1497805188 David Udell Caster Psychiatry & Neurology 219 E Saint Vrain St, Colorado Springs, CO 80903-1121 2007-01-12
1962566695 Cynthia Pearl Rose Psychiatry & Neurology 90 South Cascade Ave, Colorado Springs, CO 80903-1675 2006-12-20
1144396847 Roger D Pumphrey Psychiatry & Neurology 100 E Saint Vrain St, Ste 200, Colorado Springs, CO 80903-4940 2006-11-27
Find all providers in COLORADO SPRINGS

Competitor

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City COLORADO SPRINGS
Zip Code 80923

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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