Provider Demographics
NPI:1861713471
Name:PARK, JUN-KI (MD)
Entity type:Individual
Prefix:
First Name:JUN-KI
Middle Name:
Last Name:PARK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:105 N PARK TRL
Mailing Address - Street 2:STE. 300
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-7432
Mailing Address - Country:US
Mailing Address - Phone:678-284-0200
Mailing Address - Fax:678-284-9299
Practice Address - Street 1:105 N PARK TRL
Practice Address - Street 2:STE. 300
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-7432
Practice Address - Country:US
Practice Address - Phone:678-284-0800
Practice Address - Fax:678-284-9299
Is Sole Proprietor?:No
Enumeration Date:2010-06-17
Last Update Date:2015-03-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA09080700207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology