Provider Demographics
NPI:1932464013
Name:PARK, ARTHUR CHUL (OD)
Entity Type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:CHUL
Last Name:PARK
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:600 GARSON DR NE
Mailing Address - Street 2:APT 4104
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30324-3361
Mailing Address - Country:US
Mailing Address - Phone:206-802-4984
Mailing Address - Fax:
Practice Address - Street 1:1215 CAROLINE ST NE STE H100
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30307-2775
Practice Address - Country:US
Practice Address - Phone:404-522-8886
Practice Address - Fax:404-522-8887
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-05
Last Update Date:2016-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618002161152W00000X
GAOPT002804152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist