Organization
TRI-STATE ADVANCED PAIN MANAGEMENT
Active
Parent organization
TRI-STATE ADVANCED PAIN MANAGEMENT
Organization subpart
Yes
Provider details
NPI number
Legal business name
TRI-STATE ADVANCED PAIN MANAGEMENT
Authorized official
DR. SUK KI KIM M.D. (PRESIDENT)
(270) 684-5679
Entity
Organization
Contact information
Practice address
444 S MAIN ST, SUITE 133, MADISONVILLE, KY 42431-2846
(270) 825-4732
(270) 825-4733
Mailing address
3332 VILLA PT, SUITE 104, OWENSBORO, KY 42303-7818
(270) 684-5679
(270) 684-5753
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
17728
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64177280
—
KY
Enumeration date
06/12/2012
Last updated
06/10/2013
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