Provider Demographics
NPI:1255751749
Name:JUNG, DAVID LEE (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:LEE
Last Name:JUNG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13677 W MCDOWELL RD
Mailing Address - Street 2:
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85395-2635
Mailing Address - Country:US
Mailing Address - Phone:623-882-1500
Mailing Address - Fax:
Practice Address - Street 1:1776 WOODSTEAD CT STE 208
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-1480
Practice Address - Country:US
Practice Address - Phone:877-749-7428
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-23
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ56143208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation