Organization
JONG KIM FAMILY MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONG H KIM M.D. (OWNER)
(219) 738-3550
Entity
Organization
Contact information
Practice address
8777 BROADWAY, SUITE C, MERRILLVILLE, IN 46410-6693
(219) 738-3550
(219) 757-6727
Mailing address
8777 BROADWAY, SUITE C, MERRILLVILLE, IN 46410-6693
(219) 738-3550
(219) 757-6727
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01036861A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100200870
—
IN
Enumeration date
01/08/2008
Last updated
01/14/2009
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