MEDICARE: DR. WILLIAM JUN JEONG MD, MBA, FAANS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207T00000X	Neurological Surgery Physician	0101284376	VA
2	207T00000X	Neurological Surgery Physician	19425	NV

General Provider Information

NPI Number	:	1043656051
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM JUN JEONG MD, MBA, FAANS

Provider Business Mailing Address
First Line	:	8285 W ARBY AVE STE 220
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89113-2236
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8285 W ARBY AVE STE 220
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89113-2236
Country	:	US
Telephone Number	:	27-737-7753
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/16/2013
Last Update Date	:	12/13/2024

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