Individual
JIN-YON JEANY KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1265 UNION AVE, SUITE 184, MEMPHIS, TN 38104-3415
(901) 516-9183
(901) 516-8993
Mailing address
PO BOX 1000, DEPT # 457, MEMPHIS, TN 38148-0001
(901) 516-9183
(901) 516-8993
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
229503
NY
207RN0300X
Nephrology Physician
Primary
49525
TN
207RN0300X
Nephrology Physician
A99274
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06427772
—
MS
05
—
197290001
—
AR
01
—
4355601
BCBS
TN
01
—
P01294157
RAILROAD MEDICARE
TN
05
—
Q002438
—
TN
Enumeration date
09/26/2007
Last updated
12/17/2021
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