Jay Y Park MD, PC

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

Legal business name

JAY Y PARK MD, PC

Practice address

360 S Garden Way Ste 230
Eugene, OR 97401-8173

Phone

(541) 344-4168

Fax

(541) 743-2306

NPI assigned

Nov 5, 2008

Last updated

Jul 2, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Brandy D Jackson, RN

Title

Office Manager

Phone

(541) 344-4168

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1225843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404259200000",
    "number": "1558515494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 S GARDEN WAY STE 230",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974018173",
            "telephone_number": "541-344-4168",
            "fax_number": "541-743-2603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 S GARDEN WAY STE 230",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974018173",
            "telephone_number": "541-344-4168",
            "fax_number": "541-743-2306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAY Y PARK MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-05",
        "last_updated": "2014-07-02",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "BRANDY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "541-344-4168",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ty Jaros, DDS
• Barry S Jarvis, M.D
• Breeana C Jarvis, LCSW, MSW
• Hannah Jarvis, MS, RD, LD
• Lakotaka Dawn Jason, CADC CANDIDATE
• Jeannie Gar Yun Jay, LMFT
• Jayson Peterson, Med, LMFT, LLC
• JC Medical LLC
• Jean Daugherty Counseling
• Cheryl Lynn Jeanneret, QMHA

• MOHS-Micrographic Surgery Physician in Eugene, OR
• Providers in Eugene, OR by specialty
• MOHS-Micrographic Surgery Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2014; 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.