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Organization
SOUTHAMPTON MEDICAL PRACTICE PC
Active
Organization
SOUTHAMPTON MEDICAL PRACTICE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BYOUNG KWON CHIN MD (PRESIDENT)
(215) 357-0733
Entity
Organization
Contact information
Practice address
763 GROVE AVE, SOUTHAMPTON, PA 18966-3438
(215) 357-0733
(215) 357-1434
Mailing address
763 GROVE AVE, SOUTHAMPTON, PA 18966-3438
(215) 357-0733
(215) 357-1434
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
KEYSTONE HEALTH PLAN
0022074001
PA
Enumeration date
02/08/2007
Last updated
08/22/2020
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