Provider Demographics
NPI:1770460925
Name:PARK, JUN HYOUNG (PA-C)
Entity type:Individual
Prefix:
First Name:JUN
Middle Name:HYOUNG
Last Name:PARK
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4932 HOGAN DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-1755
Mailing Address - Country:US
Mailing Address - Phone:302-299-2629
Mailing Address - Fax:
Practice Address - Street 1:4932 HOGAN DR
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-1755
Practice Address - Country:US
Practice Address - Phone:302-299-2629
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-19
Last Update Date:2025-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant