Donald W Park, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

25318 Issued in AZ

Practice address

1101 E Missouri Ave
Phoenix, AZ 85014-2709

Phone

(602) 222-2221

Fax

(602) 266-2044

NPI assigned

Aug 11, 2005

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Eyenet Triage, PLC

  • Ophthalmology Physician
  • Phoenix, AZ
  • NPI 1932553211
  NPD (past)
• Retinal Consultants of Arizona LTD

  • Ophthalmology Physician
  • Phoenix, AZ
  • NPI 1700823051
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1123718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073515854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 32530",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850642530",
            "telephone_number": "602-265-2695",
            "fax_number": "602-265-5077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 E MISSOURI AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850142709",
            "telephone_number": "602-222-2221",
            "fax_number": "602-266-2044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "DONALD",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "AZ",
            "license": "25318",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "384230",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Park Seven Operations LLC
• Amber Kay Park
• Andrew S Park, PHARMD
• Cleopatra C Park, N.P.
• Connor Charles Park
• Jae Hyun Park, DMD, PHD
• Jennifer Park, M.D.
• Jung K Park, M.D.
• Keun Hye Park
• Kwiok Gloria Park

• Ophthalmology Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Ophthalmology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.