National Provider Identifier
Ichabod S Jung, MD
Ichabod S Jung, MD is listed in the NPPES registry with a primary specialty of Urology Physician in Jamestown, NY and a listed phone number of (716) 338-9200.
Profile Overview
- NPI
- 1497784789
- Provider Type
- Individual
- Primary Specialty
- Urology Physician
- Enumeration Date
- July 01, 2006
- Last Updated
- February 03, 2011
Practice Location
- 117 Foote Ave
- Suite 100
- Jamestown, NY 14701-6947
Phone: (716) 338-9200
Specialties
- Urology Physician (208800000X)
- Urology Physician (208800000X)
Full Record
- NPI
- 1497784789
- Entity Type
- Individual
- Last Name
- Jung
- First Name
- Ichabod
- Middle Name
- S
- Credential
- MD
- Mailing Street Address
- 117 Foote Ave
- Mailing Address Line 2
- Suite 100
- Mailing City
- Jamestown
- Mailing State
- NY
- Mailing ZIP Code
- 14701-6947
- Mailing Country
- US
- Mailing Phone
- (716) 338-9200
- Mailing Fax
- (716) 338-9250
- Practice Street Address
- 117 Foote Ave
- Practice Address Line 2
- Suite 100
- Practice City
- Jamestown
- Practice State
- NY
- Practice ZIP Code
- 14701-6947
- Practice Country
- US
- Practice Phone
- (716) 338-9200
- Practice Fax
- (716) 338-9250
- Enumeration Date
- July 01, 2006
- Last Updated
- February 03, 2011
- Sex
- Male
- Sole Proprietor
- No
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Urology Physician (208800000X), Urology Physician (208800000X)
- Other Identifiers
- 2163913 (NY)