JONG PARK


Address: 3215 N Northhills Blvd, Fayetteville, AR 72703-4424
Phone: 4799687930

JONG PARK (NPI# 1952526972) 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) 1952526972
Entity Type Individual
Full Name JONG PARK
Credential MD
Practice Address 3215 N Northhills Blvd
Fayetteville
AR 72703-4424
Mailing Address Po Box 9178
Russellville
AR 72811
Practice Telephone 4799687930
Practice Fax Number 4799684331
Mailing Telephone 4799687930
Mailing Fax Number 4799684331
Enumeration Date 2007-04-16
Last Update Date 2010-06-10
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2085R0202X Radiology
Specialization: Diagnostic Radiology
E5013 AR Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
AR 175747001 05
AR BCBS 5H161 01

Other Providers JONG PARK

NPI Name Taxonomy Address Enumeration
1386816858 Jong Keun Park Physical Medicine & Rehabilitation 232 Broad Ave Ste 208, Palisades Park, NJ 07650-1565 2008-03-25
1801826904 Jong Chan Park Internal Medicine 900 Kiely Blvd, Santa Clara, CA 95051-5329 2006-07-04
1548244460 Jong Kon Park Plastic Surgery 235 Walnut St, Framingham, MA 01702-7592 2005-12-05
1508493008 Jong Hyun Park Student in an Organized Health Care Education/Training Program 1200 N State St, Los Angeles, CA 90033-1083 2020-03-25
1205460847 Jong Park Pharmacist 4901 Spring St, Mount Pleasant, WI 53406-2901 2020-02-22
1386173870 Jong Park Internal Medicine 2100 Dorchester Ave, Boston, MA 02124-5615 2017-06-08
1265804553 Jong Park Pharmacist 4201 W Medical Center Dr, Mchenry, IL 60050-8409 2015-10-26
1356721922 Jong Kwan Park Student in an Organized Health Care Education/Training Program 30 Prospect Ave, Hackensack University Medical Center, Hackensack, NJ 07601-1915 2015-06-09
1760749352 Jong Ho Park Acupuncturist 2707 S Diamond Bar Blvd, Suite 205, Diamond Bar, CA 91765-3500 2012-04-19
1811038672 Jong T Park Physical Therapist 2906 Crossing Ct, Champaign, IL 61822-6163 2007-02-12

Office Location

Street Address 3215 N NORTHHILLS BLVD
City FAYETTEVILLE
State AR
Zip Code 72703-4424

Providers in the same location

NPI Name Taxonomy Address Enumeration
1083609150 Washington Regional Medical Center General Acute Care Hospital 3215 N Northhills Blvd, Fayetteville, AR 72703-4007 2005-09-15
1710593207 Christopher Donavan Watts Driver 3215 N Northhills Blvd, Fayetteville, AR 72703-4424 2020-09-20
1255947743 Sarah Grace Groves Physical Therapist 3215 N Northhills Blvd, Fayetteville, AR 72703-4424 2020-09-20
1063048817 Kenita Davis Nurse Practitioner 3215 N Northhills Blvd, Fayetteville, AR 72703-4424 2020-03-12
1114558996 Samar Qedan Nurse Practitioner 3215 N Northhills Blvd, Fayetteville, AR 72703-4424 2020-01-30
1740842509 Natasha Lee Wilhite Nurse Practitioner 3215 N Northhills Blvd, Fayetteville, AR 72703-4424 2019-07-02
1710473111 Cari Addington Nurse Practitioner 3215 N Northhills Blvd, Fayetteville, AR 72703-4424 2018-07-09
1275024127 Iris Louise Berry Registered Nurse 3215 N Northhills Blvd, Fayetteville, AR 72703 2018-05-27
1003304213 Brittany Huls Registered Nurse 3215 N Northhills Blvd, Fayetteville, AR 72703-4424 2018-04-24
1013447846 Paige Lauren Davis Nurse Practitioner 3215 N Northhills Blvd, Fayetteville, AR 72703-4424 2017-06-14
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1477154391 Margaret Sorrells Pharmacist 3909 N Mall Ave Attn:pharmacy, Fayetteville, AR 72703 2020-11-06
1497369631 Justin A Rand Massage Therapist 88 W Colt Square Dr, Fayetteville, Ar 72703, Fayetteville, AR 72703 2020-09-04
1235777558 Washington Regional Medical System Specialist 3264 N North Hills Blvd, Fayetteville, AR 72703 2019-12-17
1760024582 Haley Brooke Thompson Occupational Therapist 2474 E Joyce Blvd Ste 2, Null, Fayetteville, AR 72703 2019-10-14
1306492129 Bhg L, LLC Clinic/Center 8 Colt Square Drive, Fayetteville, AR 72703 2019-08-16
1306406269 Idell Marie Mitchell Optometrist Eye Clinic, 1100 N College Ave, Fayetteville, AR 72703 2019-06-13
1821574815 Toni Myer Nurse Practitioner 3 E Appleby Rd Ste 101, Fayetteville, AR 72703 2018-07-13
1306340393 Josh Kelfer Student in an Organized Health Care Education/Training Program 1125 North College Avenue, Fayetteville, AR 72703 2018-03-22
1649726449 Vantage Point of Nwa Community/Behavioral Health 4171 N. Crossover Rd, Fayetteville, AR 72703 2016-08-31
1386097137 Jason Nordstrom Speech-Language Pathologist 2664 N Valencia Ave, Fayetteville, AR 72703 2016-07-18
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Taxonomy Information

Taxonomy Code 2085R0202X
Grouping Allopathic & Osteopathic Physicians
Classification Radiology
Specialization Diagnostic Radiology

Taxonomy Definition

A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1700211653 Medical Associates of Northwest Arkansas Pa Radiology 3383 N Mana Ct Ste 102, Fayetteville, AR 72703-4965 2013-09-11
1831534346 Kevin Tyler Goelz Radiology 605 Wentworth Ct, Fayetteville, GA 30215 2013-05-10
1689859829 Santiago Miro Radiology 7302 Wakefield Dr, Fayetteville, NY 13066-9755 2008-01-07
1295858967 Garney H Fendley Radiology 3215 N. North Hills Blvd, Fayetteville, AR 72703-4424 2007-04-09
1558424986 Joseph Vincent Scrivani Radiology 5436 Springview Dr, Fayetteville, NY 13066-9678 2006-12-18
1538244751 Bernard Schneider Radiology 7064 Woodchuck Hill Rd, Fayetteville, NY 13066-9764 2006-10-26
1023190097 Andrew Bostaph Radiology 3027 Hampton Ridge Rd, Fayetteville, NC 28311-3005 2006-10-19
1326095639 Cynthia Evette P Humphries Radiology 2053 Loganberry Dr, Fayetteville, NC 28304-0804 2006-05-30
1134170160 Medical Associates of Northwest Arkansas Pa Radiology 55 W Sunbridge Dr, Fayetteville, AR 72703-1825 2006-05-15
1669430971 Carolina Imaging LLC of Fayetteville Radiology 3628 Cape Center Dr, Fayetteville, NC 28304-4406 2006-05-03
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Competitor

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City FAYETTEVILLE
Zip Code 72703

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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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