Individual
DR. JAMES K PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D., PH.D.
Contact information
Practice address
8330 BOONE BLVD STE 160, VIENNA, VA 22182-2678
(703) 354-2200
(703) 977-1728
Mailing address
4600 JOHN MARR DR, SUITE 101, ANNANDALE, VA 22003-3310
(703) 354-2200
(571) 323-3938
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
0101840533
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0101840533
STATE MEDICAL LICENSE
VA
01
—
D55608
STATE MEDICAL LICENSE
MD
01
—
MD32179
MEDICAL LICENSE NUMBER
DC
Enumeration date
01/21/2007
Last updated
02/14/2025
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