Organization
OCONEE PRIMARY CARE, L.L.C.
Active
Organization
OCONEE PRIMARY CARE, L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEN H PARK MD (OWNER/PROVIDER)
(404) 759-6436
Entity
Organization
Contact information
Practice address
1624 MARS HILL RD, SUITE B, WATKINSVILLE, GA 30677-4813
(404) 759-6436
(706) 769-2750
Mailing address
1624 MARS HILL RD, SUITE B, WATKINSVILLE, GA 30677-4813
(404) 759-6436
(706) 769-2750
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
050049
GA
Other
Enumeration date
11/18/2009
Last updated
11/18/2009
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