Provider Demographics
NPI:1568506020
Name:HONG, JUN MO (OD)
Entity Type:Individual
Prefix:
First Name:JUN
Middle Name:MO
Last Name:HONG
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3230 STEVE REYNOLDS BLVD STE 110
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-8832
Mailing Address - Country:US
Mailing Address - Phone:678-502-7395
Mailing Address - Fax:678-502-7396
Practice Address - Street 1:3230 STEVE REYNOLDS BLVD STE 110
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-8832
Practice Address - Country:US
Practice Address - Phone:678-502-7395
Practice Address - Fax:678-502-7396
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-17
Last Update Date:2012-07-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GAOPT002150152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist