NPI age
11 years
Enumerated 2015-02-13
● Active
Type 1 · Individual
Jiyoun Leah Park, PA
Park is 1 of 2 physician assistant providers in Tucker and 1 of 1333 in Georgia.
Primary specialty
Physician Assistant
Licensed in
—
0 states
Status
Active
No deactivations on record
Last NPPES update
2015-07-15
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 1333 active physician assistant providers in Georgia.
NPI age
11 years
↓ 4 yr below median (15 yr)
State licenses
1 state
7% of peers hold multiple states
Subspecialties
0
21% of peers hold subspecialties
NPI lifetime · 2015 → 2026
2015-02Enumerated in NPPES
2015
2026
Where they practice
Practice location
1468 Montreal Rd
Tucker, GA 300846901
Mailing address
1468 Montreal Rd
Tucker, GA 300846901
Specialties
-
Physician Assistant PrimaryDefinition to come...
Practice context
Part of a multi-provider practice. 23 other active providers share this practice address in NPPES.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.