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General NPI Number Information
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NPI Number | 1669979654
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Entity Type | Individual
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Provider Name | SUNG OK JEON MD
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Gender | Male
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Dates
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Enumeration Date | 04/07/2018
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Last Update Date | 11/22/2024
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Provider Practice Location Address
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Address Line | 777 BANNOCK ST
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City | DENVER
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State | CO
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Zip | 80204-4597
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Country | US
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Telephone | 303-436-4949
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Fax | 303-602-6190
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Provider Business Mailing Address
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Address Line | 777 BANNOCK ST
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City | DENVER
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State | CO
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Zip | 80204-4597
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Country | US
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Telephone | 303-436-4949
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Fax | 303-602-6190
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | MD221747
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | ME163265
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | MD61575667
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License Number State | WA
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Taxonomy #4
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 2084A2900X
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Taxonomy Name | Neurocritical Care Physician
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License Number | DR0065381
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License Number State | CO
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