Individual
JONGYEOL KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3601 4TH ST # MS 8321, LUBBOCK, TX 79430-0002
(806) 743-4999
Mailing address
3601 4TH ST # MS 8321, LUBBOCK, TX 79430-0002
(806) 743-4999
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
42653
TX
2084N0600X
Clinical Neurophysiology Physician
Primary
P4585
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10208416
—
VA
01
—
140KX
BCBS
NC
01
—
182868
MEDCOST
NC
05
—
3810003890
—
WV
05
—
5902240
—
NC
01
—
7046747
AETNA
—
01
—
806577
PARTNERS
NC
05
—
Q0142A
—
SC
Enumeration date
12/22/2005
Last updated
04/17/2024
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