Provider Demographics
NPI:1932154390
Name:SOUTHEAST MO ENT CONSULTANTS LTD
Entity Type:Organization
Organization Name:SOUTHEAST MO ENT CONSULTANTS LTD
Other - Org Name:DR CHRISTOPHER JUNG
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER-CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:H
Authorized Official - Last Name:JUNG
Authorized Official - Suffix:SR
Authorized Official - Credentials:MD
Authorized Official - Phone:573-334-7173
Mailing Address - Street 1:150 S MOUNT AUBURN RD
Mailing Address - Street 2:STE. 432
Mailing Address - City:CAPE GIRARDEAU
Mailing Address - State:MO
Mailing Address - Zip Code:63703-4910
Mailing Address - Country:US
Mailing Address - Phone:573-334-7173
Mailing Address - Fax:573-334-7185
Practice Address - Street 1:150 S MOUNT AUBURN RD
Practice Address - Street 2:STE. 432
Practice Address - City:CAPE GIRARDEAU
Practice Address - State:MO
Practice Address - Zip Code:63703-4910
Practice Address - Country:US
Practice Address - Phone:573-334-7173
Practice Address - Fax:573-334-7185
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO32408207YX0602X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YX0602XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngic AllergyGroup - Multi-Specialty