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Contact Information

KYU SIK PARK, MD
269 S CANDY LN
COTTONWOOD, AZ86326
 Phone: 928-639-6150
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Anesthesiology

207L00000X 79 Physician/Addiction Medicine
Indicates primary specialty

NPI Profile & details for KYU SIK PARK · (Male)

NPI Number 1952443202
Status Active
Credentials MD
Entity Individual
Enumeration date 02/13/2007
Last updated 01/22/2025 - More than a year ago
Sole proprietor 1 No
Identifiers
  • AZ License # 75588
  • KY License # IP922
Hospital affiliation(s)
  • SOUTHEAST MISSOURI HOSPITAL - (Acute Care)
    1701 LACEY ST
    CAPE GIRARDEAU, MO 63701
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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