Individual
DR. JENNIFER CHUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
9250 BLUE ASH RD, BLUE ASH, OH 45242-6822
(513) 792-7445
(513) 791-4042
Mailing address
237 WILLIAM HOWARD TAFT RD, 2ND FL, CBO2-3, ATTN: CREDENTIALING, CINCINNATI, OH 45219-2610
(513) 792-7441
(513) 791-4042
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
268967
NY
208100000X
Physical Medicine & Rehabilitation Physician
Primary
35.121576
OH
208100000X
Physical Medicine & Rehabilitation Physician
46125
KY
390200000X
Student in an Organized Health Care Education/Training Program
209100000X
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1062846
WELLCARE
KY
01
—
50077938
PASSPORT HEALTH
OH
01
—
7100275100
MEDICAID
KY
01
—
898704
ANTHEM
OH
01
—
94269
MEDICAID
OH
01
—
CS1435100163
CARESOURCE
OH
01
—
H249981
MEDICARE
OH
01
—
K165100
MEDICARE
KY
Enumeration date
07/03/2007
Last updated
09/22/2017
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