Individual
JIN PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1000 JOHNSON FERRY RD NE, RADIOLOGY DEPARTMENT, ATLANTA, GA 30342-1606
(404) 851-6323
Mailing address
5605 GLENRIDGE DR STE 325, ATLANTA, GA 30342-1365
(678) 553-7783
(678) 553-7793
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
060547
GA
2085R0202X
Diagnostic Radiology Physician
2005-01290
NC
2085R0204X
Vascular & Interventional Radiology Physician
Primary
060547
GA
2085R0204X
Vascular & Interventional Radiology Physician
MD430802
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
456003412
—
GA
Enumeration date
03/27/2007
Last updated
10/30/2025
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