MEDICARE: KHALDON JUNDI MD

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	2080N0001X	Neonatal-Perinatal Medicine Physician	29168	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1336173525
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KHALDON JUNDI MD

Provider Business Mailing Address
First Line	:	PO BOX 24930
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40524-4930
Country	:	US
Telephone Number	:	859-272-1146
Fax Number	:

Provider Business Practice Location Address
First Line	:	170 N EAGLE CREEK DR
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40509-9087
Country	:	US
Telephone Number	:	859-967-5778
Fax Number	:

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

Provider Enumeration Date	:	07/11/2006
Last Update Date	:	04/29/2024

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Directions to “ KHALDON JUNDI MD” Practice Location

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