Provider Demographics
NPI:1003546771
Name:HAN, JUNGWUK (MD)
Entity type:Individual
Prefix:
First Name:JUNGWUK
Middle Name:
Last Name:HAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20751 W MARKET ST
Mailing Address - Street 2:
Mailing Address - City:BUCKEYE
Mailing Address - State:AZ
Mailing Address - Zip Code:85396-7893
Mailing Address - Country:US
Mailing Address - Phone:623-463-5000
Mailing Address - Fax:623-463-5200
Practice Address - Street 1:20751 W MARKET ST
Practice Address - Street 2:
Practice Address - City:BUCKEYE
Practice Address - State:AZ
Practice Address - Zip Code:85396-7893
Practice Address - Country:US
Practice Address - Phone:623-463-5000
Practice Address - Fax:623-463-5200
Is Sole Proprietor?:No
Enumeration Date:2022-06-14
Last Update Date:2025-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ75230207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine