Organization
MYUNG KIL JEON, M.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SOOK JEON (OFFICE MANAGER)
(252) 793-5073
Entity
Organization
Contact information
Practice address
1022 US HWY 64 E, BLDG # 4, PLYMOUTH, NC 27962-9215
(252) 793-5073
(252) 793-3278
Mailing address
PO BOX 948, PLYMOUTH, NC 27962-0948
(252) 793-5073
(252) 793-3278
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
45916
BLUE CROSS BLUE SHIELD
NC
05
—
890286P
—
NC
05
—
8945916
—
NC
Enumeration date
03/18/2008
Last updated
05/23/2008
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