Basic Information
| Provider Information | |||||||||
| NPI: | 1316503121 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | JUNG | ||||||||
| FirstName: | EVELYN | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 MELLON WAY | ||||||||
| Address2: | |||||||||
| City: | LATROBE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 156501197 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 1 MELLON WAY | ||||||||
| Address2: | |||||||||
| City: | LATROBE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 156501197 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7245371485 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/16/2019 | ||||||||
| LastUpdateDate: | 06/28/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/28/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | OS020892 | PA | N | Allopathic & Osteopathic Physicians | Family Medicine | 208M00000X | OS020892 | PA | Y | Allopathic & Osteopathic Physicians | Hospitalist |
No ID Information.