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

Mr. Jung Tae Park, MD

Individual provider Adult Medicine Physician · NPI 1942291638

Mr. Jung Tae Park, MD is a General Practice in Whitwell, Tennessee. Qualified in 1966, 60 years ago. Practices with Park Medical, a 5-clinician group. Licensed in Tennessee.

Years since qualifying
60
Licensed in
TN
In the registry since
2005
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

13851 Highway 28
Whitwell, TN 37397-5373
Phone: (423) 658-9200
Fax: (423) 658-2195
Show map & directions

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

Specialties & licences

Adult Medicine Physician (primary) Taxonomy 207QA0505X · Licence MD0000010100 (TN)

Record details

NPI number1942291638
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedNovember 2, 2005
Last updated in NPPESDecember 14, 2022
Certification dateDecember 14, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyGENERAL PRACTICE
Medical schoolOTHER
Graduated 1966 (60 years in practice)
Group practice Park Medical — 5 clinicians
Accepts Medicare assignment Not indicated