Individual
HANA PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1255 HIGHWAY 54 W, FAYETTEVILLE, GA 30214-4526
(770) 719-7000
Mailing address
677 CHURCH ST NE, MARIETTA, GA 30060-1101
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
OS022985
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0935379
—
NJ
Enumeration date
04/14/2020
Last updated
12/26/2025
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