Organization
KYU PARK MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KYLE K PARK MD (PRESIDENT KYU PARK MD INC)
(419) 294-5757
Entity
Organization
Contact information
Practice address
107 HOUPT DR, UPPER SANDUSKY, OH 43351-9201
(419) 294-5757
(419) 209-0623
Mailing address
107 HOUPT DR, UPPER SANDUSKY, OH 43351-9201
(419) 294-5757
(419) 209-0623
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2199811
—
OH
Enumeration date
11/17/2005
Last updated
04/11/2008
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