Provider Demographics
NPI:1013955756
Name:JUNG, SHIRLEY OI-YUN (MD)
Entity Type:Individual
Prefix:
First Name:SHIRLEY
Middle Name:OI-YUN
Last Name:JUNG
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 1:1200 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SEARCY
Mailing Address - State:AR
Mailing Address - Zip Code:72143-7321
Mailing Address - Country:US
Mailing Address - Phone:501-268-7143
Mailing Address - Fax:501-278-3455
Practice Address - Street 1:1200 S MAIN ST
Practice Address - Street 2:
Practice Address - City:SEARCY
Practice Address - State:AR
Practice Address - Zip Code:72143-7321
Practice Address - Country:US
Practice Address - Phone:501-268-7143
Practice Address - Fax:501-278-3455
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-03
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE2499207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARH41898Medicare UPIN