Park, John Moonkeun

Park, John Moonkeun is an individual health care provider with primary practice located at 515 N 162Nd Ave Ste. 300, Omaha NE 68118-2539. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Vascular Surgery. Allopathic & Osteopathic Physicians / Vascular Surgery is his primary health care specialty. Park, John Moonkeun can be contacted via phone (402) 393-6624.

Contact Information

Primary practice address
515 N 162Nd Ave Ste. 300 Omaha NE 68118-2539
Phone: (402) 393-6624
Fax: (402) 393-6635
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 35.095909 Ohio
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X 35.095909 Ohio
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X 26509 Nebraska
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X 40563 Iowa

Profile Details

NPI number 1023394665
LBN Legal business name Park, John Moonkeun
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 27th, 2011
Last updated Feb 20th, 2015 - about 11 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1023394665 NPPES
Nebraska MEDICAID 10026135100
Nebraska MEDICAID 10026454700
Nebraska MEDICAID 47068731713
Nebraska MEDICAID 1023394665
Nebraska MEDICAID 10025724800

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