Provider Demographics
NPI:1437477718
Name:JUNG, JENNIFER LEE (MD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LEE
Last Name:JUNG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:HAN
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1675 AURORA CT STE F731
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80045-2592
Mailing Address - Country:US
Mailing Address - Phone:720-848-2507
Mailing Address - Fax:720-848-5014
Practice Address - Street 1:1675 AURORA CT STE F731
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045-2592
Practice Address - Country:US
Practice Address - Phone:720-848-2507
Practice Address - Fax:720-848-5014
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-11
Last Update Date:2017-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR0053622207W00000X
CODR.0053622207WX0110X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0110XAllopathic & Osteopathic PhysiciansOphthalmologyPediatric Ophthalmology and Strabismus Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology