Physician Compare National (NPI:1174765622)

HEALTHCARE PROVIDER: JOSEPH K KIM M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1174765622
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3577797547
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20161018000957
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	KIM
	Individual professional last name
Provider First Name	JOSEPH
	Individual professional first name
Provider Middle Name	K
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	TEMPLE UNIVERSITY SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	2007
	Individual professional's medical school graduation year
Primary Specialty	GASTROENTEROLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	INTERNAL MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	INTERNAL MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	204 MEDICAL DR
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 240
	Group Practice or individual's line 2 address
City	SHERMAN
	Group Practice or individual's city
State	TX
	Group Practice or individual's state
Zip Code	750926366
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	450324
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	TEXOMA MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	670076
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	BAYLOR SCOTT AND WHITE SURGICAL HOSPITAL AT SHERMA
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	450469
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	WILSON N JONES REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	370014
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	ALLIANCEHEALTH DURANT
	Legal business name of hospital where individual professional provides service 4
Professional Accepts Medicare Assignment	Y