Individual
HO YOUNG KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
598 W 11TH AVE, LUMBERTON, MS 39455-2350
(601) 796-4215
(601) 796-9437
Mailing address
PO BOX 1729, HATTIESBURG, MS 39403-1729
(601) 545-8700
(601) 450-2493
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
21040
MS
207Q00000X
Family Medicine Physician
28436
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04501009
—
MS
Enumeration date
10/04/2006
Last updated
03/17/2018
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