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Individual

DR. ROY EDWARD PARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
43480 YUKON DR, SUITE 214, ASHBURN, VA 20147-6984
(703) 724-0330
(703) 724-0811
Mailing address
43480 YUKON DR, SUITE 214, ASHBURN, VA 20147-6988
(703) 724-0330
(703) 724-0811

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0618001310
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
010272815
VA
Enumeration date
09/12/2006
Last updated
04/19/2011
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