Healthcare Provider Details
I. General information
NPI: 1255474359
Provider Name (Legal Business Name): SUNWOOK KIM MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 02/15/2007
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1380 E MEDICAL CENTER DR STE N1800
ST GEORGE UT
84790-2123
US
IV. Provider business mailing address
PO BOX 27128
SALT LAKE CITY UT
84127-0128
US
V. Phone/Fax
- Phone: 435-251-4100
- Fax: 435-251-4101
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | 14269662-1235 |
| License Number State | UT |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | ME77123 |
| License Number State | FL |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | 24782 |
| License Number State | NV |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: