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).
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 |
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 |
State | Issuer | Identifier | Type Code |
---|---|---|---|
SC | G07909 | 05 | |
GA | 000473459A | 05 |
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 |
Street Address |
1120 15TH STREET |
City | AUGUSTA |
State | GA |
Zip Code | 30912 |
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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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 |
Find all providers in zip 30912 |
Taxonomy Code | 2084N0402X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Psychiatry & Neurology |
Specialization | Neurology with Special Qualifications in Child Neurology |
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] |
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 |
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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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.