Provider Demographics
NPI:1598985434
Name:LIM, JUNG GOOK (MD)
Entity type:Individual
Prefix:DR
First Name:JUNG GOOK
Middle Name:
Last Name:LIM
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Gender:M
Credentials:MD
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Mailing Address - Street 1:11166 FAIRFAX BLVD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-5025
Mailing Address - Country:US
Mailing Address - Phone:703-277-3360
Mailing Address - Fax:703-277-3370
Practice Address - Street 1:11166 FAIRFAX BLVD
Practice Address - Street 2:SUITE 105
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-5025
Practice Address - Country:US
Practice Address - Phone:703-277-3360
Practice Address - Fax:703-277-3370
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2015-07-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXQ01032084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology