Organization
PARK MEDICAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SONNY Y PARK MD (OWNER)
(864) 640-0395
Entity
Organization
Contact information
Practice address
8 CEDAR GLENN WAY, SIMPSONVILLE, SC 29681-6396
(864) 640-0395
Mailing address
8 CEDAR GLENN WAY, SIMPSONVILLE, SC 29681-6396
(864) 640-0395
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
25559
SC
Other
Enumeration date
09/27/2010
Last updated
03/10/2011
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