Active NPI
Meekyung Park
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- Buford, GA
National Provider Identifier
1083990048
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- License
- 051291007
- Practice address
- 4397 Sudderth Rd
Buford, GA 30518-8794 - Phone
- (678) 546-8442
- NPI assigned
- Oct 22, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | 051291007 | IL | Primary |
Addresses
Primary practice location
4397 Sudderth Rd
Buford, GA 30518-8794
Mailing address
PSC 305
Camp Waker
Apo, AP 96218
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 051291007 | IL | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1319241600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1775779200000",
"number": "1083990048",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "MIL",
"address_1": "PSC 305",
"address_2": "CAMP WAKER",
"city": "APO",
"state": "AP",
"postal_code": "96218"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4397 SUDDERTH RD",
"city": "BUFORD",
"state": "GA",
"postal_code": "305188794",
"telephone_number": "678-546-8442"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARK",
"first_name": "MEEKYUNG",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-10-22",
"last_updated": "2026-04-10",
"certification_date": "2026-04-10",
"status": "A"
},
"taxonomies": [
{
"code": "1835P0018X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"state": "IL",
"license": "051291007",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Buford, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.