Individual
KIRK P CHUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5350 LAMME RD, DAYTON, OH 45439-3215
(937) 534-4632
(937) 534-4609
Mailing address
5350 LAMME RD, DAYTON, OH 45439-3215
(937) 534-4632
(937) 534-4609
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
35-087178
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000391335
ANTHEM
OH
05
—
2630577
—
OH
Enumeration date
06/30/2006
Last updated
11/25/2020
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