DR. ANTHONY J PARK (NPI# 1417064742) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417064742 |
| Entity Type | Individual |
| Full Name | DR. ANTHONY J PARK |
| Other Name | ANTHONY JOON PARK |
| Credential | MD |
| Practice Address |
8400 Washington Ave Racine WI 53406 |
| Mailing Address |
3301 W Forest Home Ave Milwaukee WI 53215-2843 |
| Practice Telephone | 2623213000 |
| Practice Fax Number | 2623213122 |
| Mailing Telephone | 4146476326 |
| Mailing Fax Number | 4146718860 |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | 37763 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 32253600 | 05 | |
| DEA NUMBER | BP4906206 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720386311 | Anthony T Park | Dentist | 3540 Wilshire Blvd Ste 210, Los Angeles, CA 90010-2346 | 2011-03-04 |
| 1942705769 | Anthony Sungwook Park | Physical Medicine & Rehabilitation | 300 1st Ave, Charlestown, MA 02129 | 2018-03-25 |
| 1265751697 | Anthony J Park | Urology | 10800 Magnolia Ave, Mob 2, 2nd Floor, Riverside, CA 92505-3043 | 2010-05-25 |
| 1336227438 | Anthony K. Park | Internal Medicine | 320 Lennon Ln, Walnut Creek, CA 94598-2419 | 2006-11-02 |
| Street Address |
8400 WASHINGTON AVE |
| City | RACINE |
| State | WI |
| Zip Code | 53406 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457531899 | Great Lakes Neurosurgical Associates LLC | Neurological Surgery | 8400 Washington Ave, Racine, WI 53406-3735 | 2007-11-13 |
| 1366651796 | Aurora Medical Group, Inc. | Durable Medical Equipment & Medical Supplies | 8400 Washington Ave, Racine, WI 53406-3735 | 2007-05-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578164349 | Lynn Huynh | Pharmacist | 5695 Washington Ave, Racine, WI 53406 | 2020-11-06 |
| 1659920049 | Carol Jean Cornejo | Technician | 6528 Heritage Avenue, Mt Pleasant, WI 53406 | 2019-09-09 |
| 1265913958 | Mary Goldbeck | Social Worker | 1775 Newman Rd, Mt Pleasant, WI 53406 | 2018-08-22 |
| 1669963344 | Kelly Nicole Nelson | Registered Nurse | 8800 Washington Ave Ste 200, Mount Pleasant, WI 53406 | 2018-05-29 |
| 1891212163 | Ilona Agata Pryomski | Nurse Practitioner | 9201 Washington Ave, Racine, WI 53406 | 2017-08-27 |
| 1386185106 | Margaret M. Abaogye Dds | Dentist | 4340 Newman Rd., Racine, WI 53406 | 2017-03-13 |
| 1508309212 | Rebecca Koeppen | Dietitian, Registered | 8400 Washington Ave., Racine, WI 53406 | 2016-11-29 |
| 1386194371 | Forefront Dermatology, S.c. | Dermatology | 7200 Washington Ave, Suite 100, Mount Pleasant, WI 53406 | 2016-10-13 |
| 1356891402 | Forefront Dermatology, S.c. | Dermatology | 1515 S Green Bay Rd, Racine, WI 53406 | 2016-10-12 |
| 1861841470 | Leah Marie Johnson | Dentist | 1101 South Airline Road, Racine, WI 53406 | 2016-06-06 |
| Find all providers in zip 53406 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942230909 | Sandra L. Elfering | Obstetrics & Gynecology | 3821 Spring St, Racine, WI 53405-1667 | 2006-07-04 |
| 1033174016 | Tasha R Johnson | Obstetrics & Gynecology | 3821 Spring Street, Racine, WI 53405-1667 | 2006-04-20 |
| 1215119706 | St. Luke's Health Services, Inc. | Obstetrics & Gynecology | 3801 Spring St, Racine, WI 53405-1667 | 2007-11-27 |
| 1194882514 | Andrea D Valeri | Obstetrics & Gynecology | 3821 Spring Street, Racine, WI 53405-1667 | 2007-01-03 |
| 1073523668 | Joseph Wilczynski | Obstetrics & Gynecology | 3821 Spring St, Racine, WI 53405-1667 | 2006-08-08 |
| 1831103076 | Gregory Pae | Obstetrics & Gynecology | 3821 Spring St, Racine, WI 53405-1667 | 2006-07-27 |
| 1457375370 | John A. Patterson | Obstetrics & Gynecology | 3821 Spring St, Racine, WI 53405-1667 | 2006-07-26 |
| 1730100447 | Jeffrey Musson | Obstetrics & Gynecology | 3821 Spring St, Racine, WI 53405-1667 | 2006-07-21 |
| 1780600056 | Veronica Carver | Obstetrics & Gynecology | 3821 Spring St, Racine, WI 53405-1667 | 2006-07-13 |
| 1588698989 | Andrew C. Alexander | Obstetrics & Gynecology | 3821 Spring St, Racine, WI 53405-1667 | 2006-07-10 |
| Find all providers in RACINE | ||||
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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.