Individual
DR. DUCK J KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
210 CORNELIA STREET, SUITE #204, PLATTSBURGH, NY 12901-2396
(518) 563-8050
(518) 563-8352
Mailing address
210 CORNELIA STREET, SUITE #204, PLATTSBURGH, NY 12901-2396
(518) 563-8050
(518) 563-8352
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
110604
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000405443001
BLUESHIELD NORTHEASTERN
NY
05
—
00511922
—
NY
01
—
141603686
EXCELLUS
NY
Enumeration date
05/09/2007
Last updated
10/04/2010
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