Individual
MR. JUNG TAE PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
13851 HIGHWAY 28, WHITWELL, TN 37397-5373
(423) 658-9200
(423) 658-2195
Mailing address
PO BOX 400, 13851 HIGHWAY 28, WHITWELL, TN 37397-0400
(423) 658-9200
(423) 658-2195
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
MD0000010100
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2002139
B CARE
TN
Enumeration date
11/02/2005
Last updated
12/14/2022
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