Park, Jay Y
Park, Jay Y is an individual health care provider with primary practice located at 360 S Garden Way Ste 230 , Eugene OR 97401-8187. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Park, Jay Y can be contacted via phone (541) 747-6159.Contact Information
Primary practice address
360 S Garden Way Ste 230
Eugene OR 97401-8187
Phone: (541) 747-6159
Fax: (541) 741-7249
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | MD20395 | Oregon |
Profile Details
| NPI number | 1023086857 |
|---|---|
| LBN Legal business name | Park, Jay Y |
| Credentials | M.D., P.C. |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 9th, 2006 |
| Last updated | Aug 26th, 2020 - about 6 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 | 1023086857 | NPPES |
| Oregon | MEDICAID | 071634 |
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