Individual
DR. TONY J PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1375 E 20TH AVE, DENVER, CO 80205-5422
(303) 338-4545
Mailing address
1375 E 20TH AVE, DENVER, CO 80205-5422
(303) 338-4545
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
036.131305
IL
207Q00000X
Family Medicine Physician
Primary
DR.0052360
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
023782
KAISER COMMERCIAL NUMBER
CO
05
—
20021771
—
CO
Enumeration date
04/04/2010
Last updated
02/04/2022
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