Healthcare Provider Details

I. General information

NPI: 1023645827
Provider Name (Legal Business Name): JONGIN JULIA BAEK MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2020
Last Update Date: 10/27/2025
Certification Date: 10/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2451 UNIVERSITY HOSPITAL DR # 212
MOBILE AL
36617-2300
US

IV. Provider business mailing address

2451 UNIVERSITY HOSPITAL DR # 212
MOBILE AL
36617-2300
US

V. Phone/Fax

Practice location:
  • Phone: 251-445-8282
  • Fax: 251-445-8281
Mailing address:
  • Phone: 251-445-8282
  • Fax: 251-445-8281

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberME176203
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number51142
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: