NPI age
19 years
Enumerated 2007-04-25
● Active
Type 1 · Individual
Heather Pennell Park, M.D.
Park is 1 of 3 surgery providers in Carrollton and 1 of 268 in Georgia.
Primary specialty
Surgery
Licensed in
GA
1 state
Status
Active
No deactivations on record
Last NPPES update
2016-03-14
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 268 active surgery providers in Georgia.
NPI age
19 years
≈ at median (18 yr)
State licenses
1 state
17% of peers hold multiple states
Subspecialties
0
38% of peers hold subspecialties
NPI lifetime · 2007 → 2026
2007-04Enumerated in NPPES
2007
2026
Where they practice
Practice location
157 Clinic Ave, Suite 302
Carrollton, GA 301174454
Mailing address
119 Ambulance Dr, Suite 202
Carrollton, GA 301173857
Specialties
-
Surgery PrimaryA surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 003124240A |
Practice context
Part of a multi-provider practice. 26 other active providers share this practice address in NPPES.
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