Individual
DR. JEANIE PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
550 PEACHTREE ST NE, MOT 8TH FLOOR, ATLANTA, GA 30308-2208
(404) 686-5038
(404) 686-4995
Mailing address
1670 CLAIRMONT RD, RENAL/NEPHROLOGY AND HEMODIALYSIS MED (111), DECATUR, GA 30033-4004
(404) 321-6111
(404) 235-3049
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
061137
GA
Other
Enumeration date
10/16/2007
Last updated
05/17/2011
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