Individual
JONG T KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1600 SW ARCHER RD, GAINESVILLE, FL 32610-3003
(352) 273-7841
Mailing address
PO BOX 100275, GAINESVILLE, FL 32610-0275
(352) 265-7977
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
19228
FL
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
ME132359
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
021355600
—
FL
01
—
JA298Z
MEDICARE
FL
Enumeration date
07/02/2009
Last updated
12/27/2021
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