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General NPI Number Information
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NPI Number | 1255526216
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Entity Type | Organization
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Legal Business Name | SUNGHO JUN MD PC INC
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Dates
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Enumeration Date | 09/12/2007
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Last Update Date | 10/20/2007
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Provider Practice Location Address
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Address Line | 2559 MEDICAL DR SUITE B
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City | ALAMOGORDO
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State | NM
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Zip | 88310-8703
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Country | US
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Telephone | 505-437-8828
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Fax | 505-437-4122
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Provider Business Mailing Address
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Address Line | 2559 MEDICAL DR SUITE B
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City | ALAMOGORDO
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State | NM
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Zip | 88310-8703
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Country | US
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Telephone | 505-437-8828
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Fax | 505-437-4122
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Authorized Official
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Title or Position | MEDICAL DOCTOR
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Name | SUNGHO JUN
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Credential | MD
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Telephone | 505-437-8828
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 46-81
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License Number State | NM
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