MEDICARE: KYOUNG MI KIM DAC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	U03240	MD

General Provider Information

NPI Number	:	1184571754
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KYOUNG MI KIM DAC

Provider Business Mailing Address
First Line	:	8097 MADISON BLVD STE 106
Second Line	:
City	:	MADISON
State	:	AL
Zip	:	35758-2043
Country	:	US
Telephone Number	:	912-547-7359
Fax Number	:

Provider Business Practice Location Address
First Line	:	8097 MADISON BLVD STE 106
Second Line	:
City	:	MADISON
State	:	AL
Zip	:	35758-2043
Country	:	US
Telephone Number	:	912-547-7359
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/12/2026
Last Update Date	:	03/12/2026

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