DR. BRYAN SU-HYUN JEUN (NPI# 1063674216) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063674216 |
| Entity Type | Individual |
| Full Name | DR. BRYAN SU-HYUN JEUN |
| Credential | MD |
| Practice Address |
3801 S National Ave Springfield MO 65807-5210 |
| Mailing Address |
Po Box 9007 Springfield MO 65808-9007 |
| Practice Telephone | 4172694056 |
| Mailing Telephone | 4178753000 |
| Enumeration Date | 2008-06-30 |
| Last Update Date | 2018-12-27 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085N0700X |
Radiology Specialization: Neuroradiology |
2014015319 | MO | Allopathic & Osteopathic Physicians |
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
2014015319 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 1063674216 | 05 | |
| MO | 200015934 | 05 |
| Street Address |
3801 S NATIONAL AVE |
| City | SPRINGFIELD |
| State | MO |
| Zip Code | 65807-5210 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144224569 | John W Clouse | Specialist | 3801 S National Ave, Springfield, MO 65807-5210 | 2005-06-13 |
| 1518568377 | Anna Marie Laffoon | Dietitian, Registered | 3801 S National Ave, Springfield, MO 65807-5210 | 2020-11-06 |
| 1164020822 | Amber Fullington | Nurse Practitioner | 3801 S National Ave, Springfield, MO 65807-5210 | 2020-10-15 |
| 1013522150 | Jessica N Rice | Nurse Practitioner | 3801 S National Ave, Springfield, MO 65807-5210 | 2020-09-15 |
| 1649880618 | Amber Littleton | Midwife | 3801 S National Ave, Springfield, MO 65807-5210 | 2020-08-05 |
| 1689283988 | Kelley Lizabeth Miller | Nurse Practitioner | 3801 S National Ave, Springfield, MO 65807-5210 | 2020-07-23 |
| 1801404140 | Alyssa Nicole Reeves | Nurse Practitioner | 3801 S National Ave, Springfield, MO 65807-5210 | 2020-07-22 |
| 1255949624 | Lori Marie Burkard | Speech-Language Pathologist | 3801 S National Ave, Springfield, MO 65807-5210 | 2020-07-21 |
| 1316555980 | Jessica Graff | Nurse Practitioner | 3801 S National Ave, Springfield, MO 65807-5210 | 2020-07-20 |
| 1033736137 | Asher Herbet | Anesthesiologist Assistant | 3801 S National Ave, Springfield, MO 65807-5210 | 2020-07-06 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396390241 | Karley Kassandra Murphy | Counselor | 3734 South Ave #c, Springfield, MO 65807 | 2019-08-07 |
| 1396203626 | Auvia L Logan | Dietitian, Registered | 3322 S. Campbell Ave. Suite Cc, Springfield, MO 65807 | 2019-03-05 |
| 1598250961 | Kathryn Barber | Nurse Practitioner | 3800 S National Ave Ste 700, Springfield, MO 65807 | 2018-06-27 |
| 1447764899 | Missouri Midwifery Service | Clinic/Center | 3840 South Avenue, Springfield, MO 65807 | 2017-11-21 |
| 1124530290 | Senior Living Management Group, LLC | Skilled Nursing Facility | 3705 S Jefferson Ave, Springfield, MO 65807 | 2017-10-30 |
| 1740663335 | Sarah E Kirk | Physical Therapist | 3545 S. National Ave, Springfield, MO 65807 | 2015-07-01 |
| 1750713335 | Amanda Ward | Nurse Practitioner | 2150 W Republic Rd Ste 112, Springfield, MO 65807 | 2013-08-06 |
| 1932531126 | Eugenia R Cortez | Counselor | 2124 Chesterfield Blvd., Springfield, MO 65807 | 2013-07-30 |
| 1962742866 | Missouri Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 3045 W Republic St, Springfield, MO 65807 | 2013-03-01 |
| 1033462387 | Miguel Angel Medina | Physician Assistant | 1900 South Sunshine Ave., Springfield, MO 65807 | 2012-10-24 |
| Find all providers in zip 65807 | ||||
| Taxonomy Code | 2085N0700X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Neuroradiology |
| A radiologist who diagnoses and treats diseases utilizing imaging procedures as they relate to the brain, spine and spinal cord, head, neck and organs of special sense in adults and children. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528475050 | Bachir Zoghbi | Radiology | 3801 S National Ave, Springfield, MO 65807-5210 | 2014-07-16 |
| 1386817294 | Michael Shane Walters | Radiology | 1001 E Primrose St, Springfield, MO 65807-5155 | 2008-04-11 |
| 1114033396 | Jason L. Port | Radiology | 3640 Main St, Suite 101, Springfield, MA 01107-1145 | 2006-08-21 |
| 1992818991 | Matthew J. Kuhn | Radiology | 800 E Carpenter St, Department of Radiology, Springfield, IL 62702-5324 | 2006-08-16 |
| 1083675235 | Bryan Keith Hall | Radiology | 3801 S National Ave, Springfield, MO 65807-5210 | 2006-03-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629023239 | Sharon K Wallace | Radiology | 70 Doctors' Park, Cape Girardeau, MO 63703 | 2006-05-23 |
| 1386115715 | Ayman Mohamed Nada | Radiology | 1 Hospital Dr, Columbia, MO 65212-0001 | 2018-12-11 |
| 1457832404 | Sudhir Bhimaniya | Radiology | 216 S Kingshighway Blvd, Saint Louis, MO 63110-1026 | 2018-08-28 |
| 1902293285 | Kasra Rahbar | Radiology | 510 S Kingshighway Blvd, Dept Radiology, Saint Louis, MO 63110-1016 | 2015-04-23 |
| 1275947012 | Rahul Pradeep Deolankar | Radiology | 510 S Kingshighway Blvd, Saint Louis, MO 63110-1016 | 2014-06-19 |
| 1073923223 | John Td Vu | Radiology | 510 S Kingshighway Blvd, Saint Louis, MO 63110-1016 | 2014-04-28 |
| 1477978534 | Carlos Leiva Salinas | Radiology | 1 Hospital Dr, Columbia, MO 65212-0001 | 2014-02-26 |
| 1811330954 | Michael T Bayona | Radiology | 100 Mercy Way, Joplin, MO 64804-4524 | 2013-04-08 |
| 1952663270 | Rami W Eldaya | Radiology | 510 S Kingshighway Blvd, Saint Louis, MO 63110-1016 | 2012-06-12 |
| 1992064521 | Ritu Bordia | Radiology | 1201 S Grand Blvd, Saint Louis, MO 63104-1016 | 2012-05-16 |
| Find all providers with the same taxonomy | ||||
| City | SPRINGFIELD |
| Zip Code | 65807 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.