Provider Demographics
NPI:1366403297
Name:JUNG, JULIA E (MD)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:E
Last Name:JUNG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1411 S POTOMAC ST
Mailing Address - Street 2:STE 170
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-4536
Mailing Address - Country:US
Mailing Address - Phone:303-755-8100
Mailing Address - Fax:303-755-8101
Practice Address - Street 1:1411 S POTOMAC ST
Practice Address - Street 2:STE 170
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-4536
Practice Address - Country:US
Practice Address - Phone:303-755-8100
Practice Address - Fax:303-755-8101
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-30
Last Update Date:2011-01-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO39162207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO08805245Medicaid
CO476208Medicare PIN
COH71158Medicare UPIN
CO08805245Medicaid