Basic Information
| Provider Information | |||||||||
| NPI: | 1487062709 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | JUNG | ||||||||
| FirstName: | LINDSAY | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | O.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2010 BREMO RD STE 128A | ||||||||
| Address2: | |||||||||
| City: | RICHMOND | ||||||||
| State: | VA | ||||||||
| PostalCode: | 232262444 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8779690392 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2385 COLONY CROSSING PL | ||||||||
| Address2: | |||||||||
| City: | MIDLOTHIAN | ||||||||
| State: | VA | ||||||||
| PostalCode: | 231124280 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8047392220 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/30/2014 | ||||||||
| LastUpdateDate: | 05/07/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/07/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | 2007 | AZ | N | Eye and Vision Services Providers | Optometrist | 152W00000X | 0618002630 | VA | Y | Eye and Vision Services Providers | Optometrist |
No ID Information.