# KYU PARK MD INC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1902888712
- **Authorized official:** KYLE K PARK MD (PRESIDENT KYU PARK MD INC)
- **Authorized official phone:** (419) 294-5757

## Contact information

- **Practice address:** 107 HOUPT DR, UPPER SANDUSKY, OH 43351-9201
- **Practice address phone:** (419) 294-5757
- **Practice address fax:** (419) 209-0623
- **Mailing address:** 107 HOUPT DR, UPPER SANDUSKY, OH 43351-9201
- **Mailing address phone:** (419) 294-5757
- **Mailing address fax:** (419) 209-0623

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/17/2005
- **Last updated:** 04/11/2008