Individual
DR. JONG PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3555 W 13 MILE RD STE LL-20, ROYAL OAK, MI 48073-6710
(248) 288-2280
Mailing address
39650 ORCHARD HILL PL, STE 200, NOVI, MI 48375-5392
(248) 319-0161
(248) 319-0170
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
4301503998
MI
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
4301503998
MI
Other
Enumeration date
06/08/2017
Last updated
08/15/2024
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