Individual
JIN S PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1000 CARONDELET DR STE 201B, KANSAS CITY, MO 64114
(913) 956-2250
(913) 956-2251
Mailing address
1000 CARONDELET DR STE 201B, KANSAS CITY, MO 64114-4673
(913) 956-2250
(913) 956-2251
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2008015782
MO
207RC0000X
Cardiovascular Disease Physician
0433150
KS
207RC0000X
Cardiovascular Disease Physician
194765
NY
207RC0000X
Cardiovascular Disease Physician
2008015782
MO
207RI0011X
Interventional Cardiology Physician
Primary
20080015782
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01990005
—
NY
05
—
1164400768
—
MO
01
—
P00632841
MEDICARE RAILROAD
MO
Enumeration date
01/04/2006
Last updated
11/18/2025
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