Provider Demographics
NPI:1619557907
Name:CHOI, JUNGWON ALLISON (MD)
Entity Type:Individual
Prefix:
First Name:JUNGWON
Middle Name:ALLISON
Last Name:CHOI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6027 GREEN POND DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32258-1152
Mailing Address - Country:US
Mailing Address - Phone:904-697-0572
Mailing Address - Fax:
Practice Address - Street 1:4500 N SHALLOWFORD RD
Practice Address - Street 2:
Practice Address - City:DUNWOODY
Practice Address - State:GA
Practice Address - Zip Code:30338-6476
Practice Address - Country:US
Practice Address - Phone:404-778-6920
Practice Address - Fax:404-778-6811
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-11
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program