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Individual

DR. DANIEL DAE KIM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
9601 BAPTIST HEALTH DR STE 200, LITTLE ROCK, AR 72205-6342
(201) 219-0900
Mailing address
9601 BAPTIST HEALTH DR STE 200, LITTLE ROCK, AR 72205-6342
(201) 219-0900

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
69149
WI
207WX0107X
Retina Specialist (Ophthalmology) Physician
69149
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000001463478
AMERICAN ACADEMY OF OPHTHALMOLOGY
01
13928487
CAQH
05
163944904
WI
01
69149
WI STATE LICENSE
WI
Enumeration date
03/20/2012
Last updated
03/07/2023
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