Individual
ROY B KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1153 STONEHAVEN DR, SUN PRAIRIE, WI 53590-4474
(142) 534-1747
Mailing address
1153 STONEHAVEN DR, SUN PRAIRIE, WI 53590-4474
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
73574
WI
207L00000X
Anesthesiology Physician
Primary
A160872
CA
208VP0000X
Pain Medicine Physician
73574
WI
Other
Enumeration date
04/09/2015
Last updated
08/15/2023
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