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NPI Code Detail

MEDICARE: DR. JOYCE BOBAE KIM D.O.

MEDICARE: DR. JOYCE BOBAE KIM D.O.
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
1207Q00000XFamily Medicine PhysicianDO.2392AL
2207Q00000XFamily Medicine Physician078856GA

General Provider Information

NPI Number : 1659716587
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOYCE BOBAE KIM D.O.
Provider Business Mailing Address
First Line : 3702 2ND AVE
Second Line :
City : COLUMBUS
State : GA
Zip : 31904
Country : US
Telephone Number : 706-507-9209
Fax Number :
Provider Business Practice Location Address
First Line : 3702 2ND AVE
Second Line :
City : COLUMBUS
State : GA
Zip : 31904-7408
Country : US
Telephone Number : 706-507-9209
Fax Number : 706-507-9249
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/06/2013
Last Update Date : 12/17/2020

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