Individual
DR. JACOB SUNG SIK KEUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1600 MORGAN ST, KEOKUK, IA 52632-3497
(319) 524-7150
(319) 524-5317
Mailing address
PO BOX 97, GRIDLEY, CA 95948-0097
(530) 846-9020
(530) 846-9075
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
227598
NY
207P00000X
Emergency Medicine Physician
03623
KY
207P00000X
Emergency Medicine Physician
DO-04697
IA
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
20A13246
CA
207QG0300X
Geriatric Medicine (Family Medicine) Physician
227598
NY
208D00000X
General Practice Physician
227598
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02461874
—
NY
Enumeration date
04/01/2006
Last updated
06/07/2019
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