Provider Demographics
NPI:1427070911
Name:JUNG, HONG S (DC)
Entity type:Individual
Prefix:MR
First Name:HONG
Middle Name:S
Last Name:JUNG
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2222 S HAVANA STREET
Mailing Address - Street 2:#B1
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014
Mailing Address - Country:US
Mailing Address - Phone:303-745-0200
Mailing Address - Fax:303-745-1273
Practice Address - Street 1:2222 S HAVANA STREET
Practice Address - Street 2:#B1
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014
Practice Address - Country:US
Practice Address - Phone:303-745-0200
Practice Address - Fax:303-745-1273
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4758111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
353408Medicare ID - Type Unspecified