Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Jae Hong Park

Individual provider Otolaryngology Physician · NPI 1396407011

Dr. Jae Hong Park is an Otolaryngology Physician in Detroit, Michigan. Licensed in Michigan. Registered with an NPI since 2021.

Licensed in
MI
In the registry since
2021

Practice location Address checks out

4100 John R St
Detroit, MI 48201-2013
Phone: (248) 854-4576
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Otolaryngology Physician (primary) Taxonomy 207Y00000X · Licence 4351048809 (MI)

Record details

NPI number1396407011
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedOctober 11, 2021
Last updated in NPPESOctober 11, 2021
Certification dateOctober 11, 2021

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