Provider Demographics
NPI:1619245370
Name:CHUN, JI YOUNG (PHRAM D)
Entity Type:Individual
Prefix:MRS
First Name:JI
Middle Name:YOUNG
Last Name:CHUN
Suffix:
Gender:F
Credentials:PHRAM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:456 TIORAM LN SE
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30082-5239
Mailing Address - Country:US
Mailing Address - Phone:404-518-6988
Mailing Address - Fax:
Practice Address - Street 1:456 TIORAM LN SE
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30082-5239
Practice Address - Country:US
Practice Address - Phone:404-518-6988
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-09
Last Update Date:2011-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA022156183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist