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General NPI Number Information
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NPI Number | 1013963156
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Entity Type | Individual
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Provider Name | RONALD S. KIM MD
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Gender | Male
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Dates
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Enumeration Date | 05/26/2006
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Last Update Date | 03/20/2023
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Provider Practice Location Address
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Address Line | 919 E 32ND ST
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City | AUSTIN
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State | TX
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Zip | 78705-2703
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Country | US
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Telephone | 512-476-7111
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Fax |
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Provider Business Mailing Address
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Address Line | 11824 PORTOFINO DR
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City | AUSTIN
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State | TX
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Zip | 78732-2040
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Country | US
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Telephone | 512-266-4094
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207PE0004X
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Taxonomy Name | Emergency Medical Services (Emergency Medicine) Physician
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License Number | M1186
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | M1186
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License Number State | TX
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