Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 32408 | MO |
NPI | 1265471973 |
---|---|
Provider Name | Mr. Christopher H Jung SR. |
First Address | Cape Girardeau, MO 63703-4910 |
Second Address | Cape Girardeau, MO 63703-4910 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2006 |
Last Update Date | 08/07/2007 |