Provider Demographics
NPI:1932188620
Name:CHUNG, JOHNNY S (MD)
Entity type:Individual
Prefix:DR
First Name:JOHNNY
Middle Name:S
Last Name:CHUNG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:250 CETRONIA RD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-9168
Mailing Address - Country:US
Mailing Address - Phone:610-437-2378
Mailing Address - Fax:610-820-9983
Practice Address - Street 1:250 CETRONIA RD
Practice Address - Street 2:SUITE 301
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-9168
Practice Address - Country:US
Practice Address - Phone:610-437-2378
Practice Address - Fax:610-820-9983
Is Sole Proprietor?:No
Enumeration Date:2006-01-11
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD418041208200000X, 2086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
No208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1782238OtherHIGHMARK BLUE SHIELD
PA414517OtherHEALTH ASSURANCE
PA50054677OtherNCAS
PA97378OtherGEISINGER
PA5819250OtherCIGNA
PAP3646893OtherOXFORD
PA14276474OtherTRICARE
PA20049019OtherAMERIHEALTH MERCY
PA414517OtherHEALTH AMERICA
PA820986OtherFIRST PRIORITY HEALTH
PA7231688OtherAETNA
PA2579683000OtherPERSONAL CHOICE
PA50054677OtherKEYSTONE CENTRAL
PA50054677OtherKEYSTONE SENIOR BLUE
PA2579683000OtherKEYSTONE EAST
PA50054677OtherCAPITAL BLUE CROSS
PA096996RE9Medicare ID - Type Unspecified
PA820986OtherFIRST PRIORITY HEALTH