Individual
JONG GU KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2221 EAST PROSPECT, ASHTABULA, OH 44004
(440) 997-5781
(440) 997-5725
Mailing address
2221 EAST PROSPECT, ASHTABULA, OH 44004
(440) 997-5781
(440) 997-5725
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
35365
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0217661
—
OH
Enumeration date
08/02/2006
Last updated
10/03/2007
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