Individual
YOUNG R PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1343 N FOUNTAIN BLVD, SPRINGFIELD, OH 45501
(937) 390-5029
Mailing address
PO BOX 632621, CINCINNATI, OH 45263-2621
(908) 653-9399
(908) 653-9305
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
35041645P
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0397682
—
OH
Enumeration date
08/24/2006
Last updated
07/08/2007
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