JEONG MI PARK MD NPI 1588652424

NPI Information

NPI: 1588652424
Provider Name: JEONG MI PARK, MD
Classification: Radiology - 2085R0202X
Entity Type: Individual

Specialization: Diagnostic Radiology

Organization: UNIVERSITY OF ALABAMA HEALTH SERVICES FOUNDATION,PC

PECOS Registration: Yes

Address:
619 19TH ST S
BIRMINGHAM, AL
ZIP 35249
Phone: (205) 934-4011
Get Directions

Jeong Mi Park, MD is a diagnostic radiology radiology in Birmingham, AL with 39 years of experience. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. Jeong Mi Park, MD NPI is 1588652424. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

619 19TH ST S
BIRMINGHAM, AL
ZIP 35249
Phone: (205) 934-4011

The NPI 1588652424 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 10/13/2005 and was last updated on 8/7/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2085R0202X	Radiology	Diagnostic Radiology	SP172	IOWA	No
2	2085R0202X	Radiology	Diagnostic Radiology	036-137173	ILLINOIS	No
3	2085R0204X	Radiology	Vascular & Interventional Radiology	SP172	IOWA	No
4	2085U0001X	Radiology	Diagnostic Ultrasound	SP172	IOWA	No
5	2085R0202X	Radiology	Diagnostic Radiology	L.4696	ALABAMA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0460378	MEDICAID	IOWA
2	38647	OTHER	IOWA	WELLMARK BCBS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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