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Organization
PARK PATHOLOGY ASSOCIATES INC
Active
Organization
PARK PATHOLOGY ASSOCIATES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOON PARK MD (PRESIDENT)
(419) 468-0708
Entity
Organization
Contact information
Practice address
269 PORTLAND WAY S, GALION, OH 44833-2312
(800) 594-1876
Mailing address
5620 SOUTHWYCK BLVD, TOLEDO, OH 43614-1501
(800) 594-1876
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000163396
ANTHEM
OH
05
—
0690453
—
OH
01
—
CF1562
RAILROAD MEDICARE
—
Enumeration date
09/13/2005
Last updated
07/21/2022
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