Park, Clinton Sangkyu
Park, Clinton Sangkyu is an individual health care provider with primary practice located at 500 S Henderson St Ste 200 , Fort Worth TX 76104-2154. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Therapeutic Radiology, Allopathic & Osteopathic Physicians / Radiation Oncology. Allopathic & Osteopathic Physicians / Radiation Oncology is his primary health care specialty. Park, Clinton Sangkyu can be contacted via phone (817) 413-1500.Contact Information
Primary practice address
500 S Henderson St Ste 200
Fort Worth TX 76104-2154
Phone: (817) 413-1500
Fax: (817) 413-1499
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Therapeutic Radiology | 2085R0203X | BP10022820 | Texas |
| Allopathic & Osteopathic Physicians / Radiation Oncology | 2085R0001X | N3228 | Texas |
Profile Details
| NPI number | 1295932242 |
|---|---|
| LBN Legal business name | Park, Clinton Sangkyu |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 2nd, 2007 |
| Last updated | Dec 9th, 2021 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1295932242 | NPPES |
| Texas | Other | P00764078 | RAILROAD MEDICARE |
| Texas | Other | 8CA240 | RAILROAD MEDICARE |
| Texas | MEDICAID | 202476201 | RAILROAD MEDICARE |
| Texas | MEDICAID | 202476202 | RAILROAD MEDICARE |
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