Individual
JOSEPHINE KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1090 COMMERCE DR, PRESCOTT, AZ 86305-3700
(928) 583-1000
Mailing address
1090 COMMERCE DR, PRESCOTT, AZ 86305-3700
(928) 583-1000
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
32716
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
861353
—
AZ
01
—
AW6618
HEALTHNET
AZ
01
—
AZ0753660
BCBS PROV NUMBER
AZ
Enumeration date
09/13/2006
Last updated
04/29/2024
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