Individual
DR. KYU-SIK PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
269 S CANDY LN, COTTONWOOD, AZ 86326
(928) 639-6150
Mailing address
1200 N BEAVER ST, ATTN: PAYER CREDENTIALING, FLAGSTAFF, AZ 86001-3118
(928) 213-6235
(928) 213-6292
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
75588
AZ
207L00000X
Anesthesiology Physician
IP922
KY
Other
Enumeration date
02/13/2007
Last updated
01/22/2025
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