Provider Demographics
NPI:1083691927
Name:HONG, HYUN JUNG (MD)
Entity Type:Individual
Prefix:
First Name:HYUN
Middle Name:JUNG
Last Name:HONG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4834 SPARKS BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89436-8215
Mailing Address - Country:US
Mailing Address - Phone:775-356-8100
Mailing Address - Fax:775-356-8101
Practice Address - Street 1:4834 SPARKS BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89436-8215
Practice Address - Country:US
Practice Address - Phone:775-356-8100
Practice Address - Fax:775-356-8101
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-30
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NV9830207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002016868Medicaid
H43322Medicare UPIN
NV35191Medicare ID - Type Unspecified