Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 35131937 | OH |
Y | 207XS0117X | Orthopaedic Spine Surgeon | 25335 | WV |
NPI | 1265725535 |
---|---|
Provider Name | Jeffery D Kim |
First Address | Huntington, WV 25701-3655 |
Second Address | Huntington, WV 25701-3655 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2011 |
Last Update Date | 17/11/2021 |