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General NPI Number Information
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NPI Number | 1275610206
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Entity Type | Individual
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Provider Name | JE HONG KIM MD
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Gender | Male
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 11/06/2007
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Provider Practice Location Address
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Address Line | 177 ENCLAVE DRIVE
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City | NEW CASTLE
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State | PA
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Zip | 16105-3207
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Country | US
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Telephone | 724-658-5523
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Fax | 724-658-8039
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Provider Business Mailing Address
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Address Line | 177 ENCLAVE DRIVE
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City | NEW CASTLE
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State | PA
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Zip | 16105-3207
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Country | US
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Telephone | 724-658-5523
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Fax | 724-658-8039
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AK000400L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | MD036380L
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number | MD036380L
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License Number State | PA
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