Individual
JACOB CHUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4725 WELLINGTON ST, GREENVILLE, TX 75401-4945
(903) 455-0300
(903) 455-0301
Mailing address
4725 WELLINGTON ST, GREENVILLE, TX 75401-4945
(903) 455-0300
(903) 455-0301
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
L9146
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
214090701
—
TX
01
—
8CJ777
BCBS IND. NUMBER
TX
Enumeration date
12/09/2005
Last updated
02/15/2019
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