Individual
IN KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
231 E CHESTNUT ST, LOUISVILLE, KY 40202-1821
(502) 629-6000
(502) 629-5991
Mailing address
PO BOX 909, LOUISVILLE, KY 40201-0909
(502) 629-6000
(502) 629-5991
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
37520
KY
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
Primary
37520
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200391750
—
IN
05
—
64055627
—
KY
Enumeration date
12/02/2005
Last updated
09/04/2014
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