Individual
DR. JEANIE HEE-KYUNG CHUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D., PHD
Contact information
Practice address
925 RUSH DR, SALIDA, CO 81201-9665
(719) 539-4600
(719) 539-4629
Mailing address
7300 RANCH ROAD 2222, BUILDING 1, STE 200, AUSTIN, TX 78730
(512) 628-0465
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
38765
CO
207N00000X
Dermatology Physician
Primary
CDRH.0038765
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
014977
KAISER COMMERCIAL NUMBER
CO
05
—
82157227
—
CO
Enumeration date
10/16/2006
Last updated
02/23/2023
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