Provider Demographics
NPI:1700093788
Name:JHUNG, JHUNG WOOCK (MD)
Entity Type:Individual
Prefix:
First Name:JHUNG
Middle Name:WOOCK
Last Name:JHUNG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2234 COLONIAL BLVD
Mailing Address - Street 2:ATTN: PAYER CONTRACTING & RELATIONS DEPT.
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-1412
Mailing Address - Country:US
Mailing Address - Phone:239-931-7342
Mailing Address - Fax:239-931-7385
Practice Address - Street 1:725 RESERVOIR AVE
Practice Address - Street 2:SUITE 104 & 301B
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02910-4448
Practice Address - Country:US
Practice Address - Phone:401-275-8110
Practice Address - Fax:401-275-8116
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2016-10-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
RI4564207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI0124684OtherCIGNA
FL440985OtherWELLCARE
RIAA469185OtherHARVARD PILGRIM
RI7963433OtherAETNA
FLP01699012OtherRR MEDICARE
RI007002237Medicare PIN
FL440985OtherWELLCARE