Provider Demographics
NPI:1376778639
Name:CHAVEZ, JUNEYOUNG LYNN (MD)
Entity Type:Individual
Prefix:DR
First Name:JUNEYOUNG
Middle Name:LYNN
Last Name:CHAVEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JUNEYOUNG
Other - Middle Name:LYNN
Other - Last Name:YI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:175 N MEDICAL DRIVE E 5TH FLOOR
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84132-0001
Mailing Address - Country:US
Mailing Address - Phone:801-581-6908
Mailing Address - Fax:
Practice Address - Street 1:1600 W ANTELOPE DR
Practice Address - Street 2:
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84041-1120
Practice Address - Country:US
Practice Address - Phone:801-213-1214
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-15
Last Update Date:2021-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT97814321205207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery