Provider Demographics
NPI:1316941263
Name:JUNG, MATTHEW T (MD)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:T
Last Name:JUNG
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5200 COMMERCE CROSSINGS DR FL 3
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40229-2182
Mailing Address - Country:US
Mailing Address - Phone:502-253-4924
Mailing Address - Fax:502-789-5750
Practice Address - Street 1:4003 KRESGE WAY STE 300
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-4652
Practice Address - Country:US
Practice Address - Phone:502-897-5139
Practice Address - Fax:502-896-6218
Is Sole Proprietor?:No
Enumeration Date:2005-06-09
Last Update Date:2024-03-01
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Provider Licenses
StateLicense IDTaxonomies
KY343492086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64439433Medicaid
KY64439433Medicaid
KYG86521Medicare UPIN