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NPI 1326049495

NPI 1326049495 : NAK YOON PAEK M.D. : JACKSONVILLE, FL

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General NPI Number Information
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    NPI Number           |    1326049495
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    Entity Type          |    Individual 
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    Provider Name        |    NAK YOON PAEK M.D.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    08/10/2005
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    Last Update Date     |    07/09/2007
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Provider Practice Location Address
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    Address Line         |    424 N HOGAN ST 
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    City                 |    JACKSONVILLE
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    State                |    FL
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    Zip                  |    32202-4104
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    Country              |    US
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    Telephone            |    904-354-5340
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    Fax                  |    904-354-5342
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Provider Business Mailing Address
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    Address Line         |    424 N HOGAN ST 
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    City                 |    JACKSONVILLE
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    State                |    FL
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    Zip                  |    32202-4104
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    Country              |    US
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    Telephone            |    904-354-5340
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    Fax                  |    904-354-5342
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    207Q00000X
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    Taxonomy Name        |    Family Medicine Physician
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    License Number       |    ME 33652
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    License Number State |    FL
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