MEDICARE: JENNIFER LEE JUNG M.D.

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	207W00000X	Ophthalmology Physician	DR0053622	CO
2	207WX0110X	Pediatric Ophthalmology and Strabismus Specialist Physician Physician	DR.0053622	CO

General Provider Information

NPI Number	:	1437477718
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER LEE JUNG M.D.

Provider Business Mailing Address
First Line	:	1675 AURORA CT STE F731
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80045-2592
Country	:	US
Telephone Number	:	720-848-2507
Fax Number	:	720-848-5014

Provider Business Practice Location Address
First Line	:	1675 AURORA CT STE F731
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80045-2592
Country	:	US
Telephone Number	:	720-848-2507
Fax Number	:	720-848-5014

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

Provider Enumeration Date	:	05/11/2010
Last Update Date	:	10/25/2017

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