Healthcare Provider Details

I. General information

NPI: 1407559198
Provider Name (Legal Business Name): JOON YUP KIM MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: JASON KIM MD

II. Dates (important events)

Enumeration Date: 03/23/2023
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 UNIVERSITY DR
HERSHEY PA
17033-2360
US

IV. Provider business mailing address

500 UNIVERSITY DR
HERSHEY PA
17033-2360
US

V. Phone/Fax

Practice location:
  • Phone: 717-531-1826
  • Fax:
Mailing address:
  • Phone: 717-531-1826
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD494650
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: