MEDICARE: DR. JAMES D KIM MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	62214-20	WI
2	207W00000X	Ophthalmology Physician	01083315A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1255657151
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES D KIM MD

Provider Business Mailing Address
First Line	:	7802 W JEFFERSON BLVD STE A
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46804-4138
Country	:	US
Telephone Number	:	260-305-2822
Fax Number	:	260-305-2829

Provider Business Practice Location Address
First Line	:	7802 W JEFFERSON BLVD STE A
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46804-4138
Country	:	US
Telephone Number	:	260-305-2822
Fax Number	:	260-305-2829

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/16/2010
Last Update Date	:	08/05/2022

Similar Medicare Providers

1518609429 — INDIANA RETINA CENTER LLC
Practice Location Address:

7802 W JEFFERSON BLVD STE A
FORT WAYNE, IN
46804-4138

Practice Phone: 260-305-2822
Practice Fax: 260-305-2829

1790862027 — DAWN BENSON DDS
Practice Location Address:

7810 W JEFFERSON BLVD
FORT WAYNE, IN
46804-4138

Practice Phone: 260-436-7175
Practice Fax:

1932248788 — AFFORDABLE DENTURES - FORT WAYNE, P.C.
Practice Location Address:

7810 W JEFFERSON BLVD
FORT WAYNE, IN
46804-4138

Practice Phone: 260-436-7175
Practice Fax:

1598806937 — OBSTETRICS AND GYNECOLOGY ASSOCIATES OF FORT WAYNE PC
Practice Location Address:

7802 W JEFFERSON BLVD
FORT WAYNE, IN
46804-4138

Practice Phone: 260-459-2113
Practice Fax: 260-459-6625

1508183427 — DR. MOHAMED G GENDY M.D.
Practice Location Address:

7802 W JEFFERSON BLVD STE A
FORT WAYNE, IN
46804-4138

Practice Phone: 260-305-2822
Practice Fax: 260-305-2829

1649551250 — AFFORDABLE DENTURES - FORT WAYNE, P.C.
Practice Location Address:

7810 W JEFFERSON BLVD
FORT WAYNE, IN
46804-4138

Practice Phone: 260-436-7175
Practice Fax: 260-436-9016

Directions to “ DR. JAMES D KIM MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.