MR. JUNG TAE PARK


Address: 13851 Highway 28, Whitwell, TN 37397-5373
Phone: 4236589200

MR. JUNG TAE PARK (NPI# 1942291638) 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) 1942291638
Entity Type Individual
Full Name MR. JUNG TAE PARK
Credential MD
Practice Address 13851 Highway 28
Whitwell
TN 37397-5373
Mailing Address Po Box 400
13851 Highway 28
Whitwell
TN 37397-0400
Practice Telephone 4236589200
Practice Fax Number 4236582195
Mailing Telephone 4236589200
Mailing Fax Number 4236582195
Enumeration Date 2005-11-02
Last Update Date 2008-11-18
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207QA0505X Family Medicine
Specialization: Adult Medicine
MD0000010100 TN Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
TN B CARE 2002139 01

Other Providers JUNG PARK

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1194919209 Jung Hoon Park Dentist 5249 Duke St Ste 210, Alexandria, VA 22304-2907 2007-08-31
1124006523 Jung I. Park Specialist 8825 Crestwood Ave, Munster, IN 46321-2711 2006-01-05
1679004873 Jung Mi Park Hospitalist 49 Jesse Hill Jr Dr Se, Atlanta, GA 30303-3049 2017-03-21
1417302621 Jung Park Technician/Technologist 11112 Atlantic Ave, South Richmond Hill, NY 11419-1158 2016-04-26
1053601161 Jung Eun Park Pediatrics 6345 Center Dr Bldg 14, Norfolk, VA 23502-4105 2011-04-10
1174855738 Jung Park Internal Medicine 8110 Woodman Ave, Panorama City, CA 91402 2010-02-08
1659517902 Jung Park Orthopaedic Surgery 3401 N Broad St, Outpatient Building 6th Fl., Philadelphia, PA 19140-5103 2008-12-16

Office Location

Street Address 13851 HIGHWAY 28
City WHITWELL
State TN
Zip Code 37397-5373

Providers in the same location

NPI Name Taxonomy Address Enumeration
1225409147 Whitwell Medical Plaza Clinic/Center 13851 Highway 28, Whitwell, TN 37397-5373 2015-10-19
1356745848 Kimberly Gean Redfearn Nurse Practitioner 13851 Highway 28, Whitwell, TN 37397-5373 2014-10-13
1083982243 Brenda Ross Md PC Family Medicine 13851 Highway 28, Whitwell, TN 37397-5373 2011-12-02

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1760972202 Specialized Behavior Solutions Behavioral Analyst 360 Looneys Creek Dr, Whitwell, TN 37397 2018-05-10
1134285125 Frederick Kirk Mcdermott Counselor 13810 Hwy 28, Suite B, Whitwell, TN 37397 2006-12-28
1295811156 Hooper Drug Store Pharmacist 325 E. Spring Street Po 129, Whitwell, TN 37397-0129 2006-10-31
1477627768 Whitwell Pharmacy Inc Pharmacy 13810 Highway 28, Whitwell, TN 37397-5365 2006-11-20
1689961104 Whitwell Senior Living, LLC Assisted Living Facility 13960 Highway 28, Whitwell, TN 37397-5366 2011-07-05
1043271091 Nonie Ivey Linder Social Worker 720 Teague Rd, Whitwell, TN 37397-5982 2006-03-29
1447471909 Ingrid Rene Long Registered Nurse 295 Scissomtown Rd, Whitwell, TN 37397-6601 2007-05-01
1083228209 Tarrah Davis Nurse Practitioner 205 Fiddlers Dr, Whitwell, TN 37397-8918 2020-09-04

Taxonomy Information

Taxonomy Code 207QA0505X
Grouping Allopathic & Osteopathic Physicians
Classification Family Medicine
Specialization Adult Medicine

Taxonomy Definition

Definition to come.

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1750902177 R&m Consultants LLC Family Medicine 208 N Roan St, Johnson City, TN 37601-4735 2020-04-27
1124656616 Carebridge Medical Group, PC Family Medicine 926 Main St Ste B, Nashville, TN 37206-3614 2020-03-30
1104456052 Briana Arnett Family Medicine 2308 Memorial Blvd Ste D, Springfield, TN 37172-3929 2020-01-20
1326552225 Tiffany Danielle Turner Family Medicine 1045 Horse Head Lane, Pikeville, TN 37367 2017-11-30
1871928556 Shirley Gravenor Family Medicine 2636 Park Creek Dr, Germantown, TN 38139-6556 2013-09-12
1952733396 Unity Health Home, Inc Family Medicine 201 Jordan Rd, Suite 200, Franklin, TN 37067-4495 2013-08-08
1447503842 Charlene Crowder Matthews Family Medicine 157 Highway 25 E, Newport, TN 37821-8157 2012-10-23
1295007730 Anthony Glen Justice Family Medicine 11911 Kingston Pike, Suite 201, Knoxville, TN 37934-4602 2012-01-30
1386878957 Holly Spurlock Blankenship Family Medicine 370 Doolittle Rd Ste 1, Woodbury, TN 37190-1129 2009-05-11
1447454525 Gay Kirchner Battle Family Medicine 2309 Granite Dr, Johnson City, TN 37604-2172 2007-06-13
Find all providers with the same taxonomy

Competitor

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City WHITWELL
Zip Code 37397

Improve Information

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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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