Provider Demographics
NPI:1417516980
Name:JEON, EUN KYUNG (PHD)
Entity Type:Individual
Prefix:DR
First Name:EUN KYUNG
Middle Name:
Last Name:JEON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:JULIE
Other - Middle Name:
Other - Last Name:JEON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:250 HAWKINS DR
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242-1012
Mailing Address - Country:US
Mailing Address - Phone:319-335-8703
Mailing Address - Fax:319-335-8851
Practice Address - Street 1:250 HAWKINS DR
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52242-1012
Practice Address - Country:US
Practice Address - Phone:319-335-8703
Practice Address - Fax:319-335-8851
Is Sole Proprietor?:No
Enumeration Date:2019-06-10
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA000755231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist