Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | A82485 | CA |
Y | 208600000X | Surgeon | A82485 | CA |
N | 2086X0206X | Surgical Oncologist | 280363 | NY |
N | 2086X0206X | Surgical Oncologist | 51413 | KY |
NPI | 1295804052 |
---|---|
Provider Name | Mr. Joseph Kim |
First Address | Lexington, KY 40536 |
Second Address | Lexington, KY 40536 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2006 |
Last Update Date | 01/08/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A400128758 | (02) | NY |