Healthcare Provider Details

I. General information

NPI: 1255789277
Provider Name (Legal Business Name): JANE CHUNG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2016
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6335 HOSPITAL PKWY STE 203
JOHNS CREEK GA
30097-1551
US

IV. Provider business mailing address

6335 HOSPITAL PKWY STE 203
JOHNS CREEK GA
30097-1551
US

V. Phone/Fax

Practice location:
  • Phone: 678-843-5400
  • Fax:
Mailing address:
  • Phone: 678-843-5400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number008224
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: