Individual
DR. JAY K. PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6367 E TANQUE VERDE ROAD, SUITE 200, TUCSON, AZ 85715-3832
(520) 290-5888
(520) 290-5551
Mailing address
6367 E TANQUE VERDE ROAD, SUITE 200, TUCSON, AZ 85715-3832
(520) 290-5888
(520) 290-5551
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
20616
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04-06481
EVERCARE
AZ
05
—
168337
—
AZ
01
—
AZ0710970
BLUE CROSS BLUE SHIELD
AZ
Enumeration date
10/11/2005
Last updated
07/09/2007
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