Individual
DR. KEVIN U PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1265 HIGHWAY 54 W, SUITES 102 AND 308, FAYETTEVILLE, GA 30214-4548
(770) 460-1900
(770) 719-1214
Mailing address
900 CIRCLE 75 SEPKWY 1700, ATLANTA, GA 30339-3087
(770) 953-6929
(770) 953-6972
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
74050
GA
207XS0117X
Orthopaedic Surgery of the Spine Physician
074050
GA
Other
Enumeration date
06/25/2009
Last updated
08/11/2022
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