YONG D. PARK


Address: 1120 15th Street, Augusta, GA 30912
Phone: 7067213371

YONG D. PARK (NPI# 1760582712) 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) 1760582712
Entity Type Individual
Full Name YONG D. PARK
Credential MD
Practice Address 1120 15th Street
Augusta
GA 30912
Mailing Address 1499 Walton Way
Ste 1400
Augusta
GA 30901-2650
Practice Telephone 7067213371
Practice Fax Number 7067213377
Mailing Telephone 7068286410
Enumeration Date 2006-09-22
Last Update Date 2011-03-31
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2084N0402X Psychiatry & Neurology
Specialization: Neurology with Special Qualifications in Child Neurology
035114 GA Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
SC G07909 05
GA 000473459A 05

Other Providers YONG PARK

NPI Name Taxonomy Address Enumeration
1194322495 Yong Sue Park Psychologist 1913 Wilshire Blvd, Los Angeles, CA 90057-3604 2020-10-08
1972027225 Yong Suel Park Dentist 292 Route 94, Vernon, NJ 07462-3181 2017-07-28
1699047407 Yong Hoon Park Acupuncturist 1911 Commercenter East, Suite 107, San Bernardino, CA 92408 2012-02-09
1316238470 Yong Hwa Park General Practice 25676 Island Lake Dr, Novi, MI 48374-2175 2011-04-25
1154560696 Yong Woon Park Chiropractor 5049 Birchwood Ave, Skokie, IL 60077-3349 2009-02-06
1205984317 Yong J Park Optometrist 2609 Foothill Blvd, La Crescenta, CA 91214-3511 2007-01-08
1205913761 Yong Park Emergency Medicine 506 4th St Nw, Jasper, FL 32052-6603 2006-11-01
1497869499 Yong Ho Park Surgery 501 West Riverside Avenue, Superior, MT 59872-0847 2006-08-18
1811374325 Yong Park Pharmacist 520 W Washington St, Sequim, WA 98382-3279 2015-05-05
1922388404 Yong J Park Pharmacist 4801 N Lincoln Ave, Chicago, IL 60625-1915 2011-08-28

Office Location

Street Address 1120 15TH STREET
City AUGUSTA
State GA
Zip Code 30912

Providers in the same location

NPI Name Taxonomy Address Enumeration
1447237375 Ricardo Azziz Obstetrics & Gynecology 1120 15th Street, Augusta, GA 30912-0004 2005-12-30
1174094668 Mary Gabrielle Helfgott Advanced Practice Midwife 1120 15th Street, Ba #7513, Augusta, GA 30912 2018-12-10
1912492471 Sarah Crumley Asmann Nurse Practitioner 1120 15th Street, Department of Surgery, Augusta, GA 30912 2018-06-27
1912499286 Jillian Marie Soto Family Medicine 1120 15th Street, Augusta, GA 30912 2018-06-03
1447740741 Amanda Meredith Saxon Nurse Practitioner 1120 15th Street, Bbr 6518, Augusta, GA 30912 2018-05-14
1447757968 Mohamed M Meghil Student in an Organized Health Care Education/Training Program 1120 15th Street, Gc-1337, Augusta, GA 30912 2018-04-11
1942721667 Christopher Glen Jackson Emergency Medicine 1120 15th Street, Augusta, GA 30912 2017-07-03
1063933000 Andrea Martinez-velez Anesthesiology 1120 15th Street, Augusta, GA 30912 2017-06-29
1063941409 Viviam Skarleth Trejo Surgery 1120 15th Street, Augusta, GA 30912 2017-06-08
1548799976 Alexander Herzog Internal Medicine 1120 15th Street, Augusta, GA 30912 2017-06-08
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1548885940 Hannah Gullickson Folsom Family Medicine 1459 Laney Walker Blvd Ae 3042, Augusta, GA 30912 2020-06-11
1487278909 Robert Kennedy Internal Medicine Augusta University Internal Medicine Residency Program, 1120 15th Street, Bi 5070, Augusta, GA 30912 2020-06-01
1952968737 Kayla M. Lasota Pediatrics 11230 115th St Ae3042, Augusta, GA 30912 2019-05-28
1003379280 Kayla Cox Internal Medicine 1120 15th St Bi5070, Augusta, GA 30912 2019-04-13
1619435740 Justin Ray Mackert Student in an Organized Health Care Education/Training Program Augusta University, 1120 15th Street, Gc 5110, Augusta, GA 30912 2019-03-07
1417444167 Victor Celis Dentist John Wesley Gilbert Dr, Augusta, GA 30912 2018-04-18
1487157921 Julie Ann Matsen Student in an Organized Health Care Education/Training Program 997 St. Sebastian Way, Eg-2021-10, Augusta Univ., Dept. of Psychiatry & Health Behavior, Augusta, GA 30912 2018-03-12
1497287031 Luke Yuung-jier Chang Ophthalmology 1120 15th St # Ba2720, Augusta, GA 30912 2017-04-02
1821537622 Lashawn Kay Boone Nurse Practitioner 1445 Harper St, Augusta, GA 30912 2017-02-14
1134675564 Arnab Saha Internal Medicine 1120 15 Th St., Augusta, GA 30912 2016-08-26
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Taxonomy Information

Taxonomy Code 2084N0402X
Grouping Allopathic & Osteopathic Physicians
Classification Psychiatry & Neurology
Specialization Neurology with Special Qualifications in Child Neurology

Taxonomy Definition

A Child Neurologist specializes in neurology with special skills in diagnosis and treatment of neurologic disorders of the neonatal period, infancy, early childhood, and adolescence.
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
1932768389 Uloma Chinyere Ibezim Psychiatry & Neurology 1446 Harper St, Augusta, GA 30912-0012 2019-06-10
1104040690 Suzanne Margaret Strickland Psychiatry & Neurology 1120 15th St, Augusta, GA 30912-0004 2007-04-13
1215048269 Elizabeth A. Sekul Psychiatry & Neurology 1120 15th St, Augusta, GA 30912-0004 2006-08-31
1285744920 James E. Carroll Psychiatry & Neurology 1120 15th St, Augusta, GA 30912-0004 2006-08-30
1922053321 Bernard L Maria Psychiatry & Neurology 1120 15th St, Augusta, GA 30912-0004 2006-05-23

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1376998096 Coga Health Psychiatry & Neurology 139 Altama Connector, Pmb 316, Brunswick, GA 31525-1888 2016-05-02
1376961565 Anna Wilson Bunker Psychiatry & Neurology 1086 1/2 Baxter St Ste A, Athens, GA 30606-6316 2014-04-03
1386819381 Kohilavani Velayudam Psychiatry & Neurology 761 Walther Road, Suite 100, Lawrenceville, GA 30046 2008-04-30
1952575763 Pierre Richard Fequiere Psychiatry & Neurology 705 17th St Ste 106, Columbus, GA 31901 2008-04-14
1609921881 Asma Qureshi Fischer Psychiatry & Neurology 460 North Belair Rd, Evans, GA 30801 2007-01-25
1407910607 South Georgia Neurological Associates, P.C. Psychiatry & Neurology 907 18th St E Ste 190, Tifton, GA 31794-3600 2006-12-21
1093884355 Aijaz A Khalid Psychiatry & Neurology 170 Camden Hill Rd Ste A, Lawrenceville, GA 30045-7418 2006-11-08
1912978065 Enrique J. Fernandez Psychiatry & Neurology 3226-c Hampton Avenue, Brunswick, GA 31520-4254 2006-01-27
1841677010 Michelle Tutmaher Psychiatry & Neurology 1400 Tullie Rd Ne, Atlanta, GA 30329-2309 2015-04-27
1326470246 Sonam Chandra Mhohan Bhalla Psychiatry & Neurology 1001 Johnson Fy Rd Ne, Atlanta, GA 30342-1605 2013-08-01
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Competitor

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City AUGUSTA
Zip Code 30912

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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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