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NPI Code Detail

MEDICARE: KYONGCHOL KIM MD

MEDICARE: KYONGCHOL KIM MD
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
1207R00000XInternal Medicine Physician060288GA
2207RG0300XGeriatric Medicine (Internal Medicine) Physician43029TN

General Provider Information

NPI Number : 1740265677
Entity Type Code : Individual
Provider Name (Legal Business Name) : KYONGCHOL KIM MD
Provider Business Mailing Address
First Line : 2333 MCCALLIE AVE
Second Line :
City : CHATTANOOGA
State : TN
Zip : 37404-3258
Country : US
Telephone Number : 423-493-1595
Fax Number : 423-493-6735
Provider Business Practice Location Address
First Line : 960 JOE FRANK HARRIS PKWY SE
Second Line :
City : CARTERSVILLE
State : GA
Zip : 30120-2129
Country : US
Telephone Number : 470-490-2142
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/14/2005
Last Update Date : 09/16/2025

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Directions to “ KYONGCHOL KIM MD” Practice Location

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