Organization
TRI-STATE ADVANCED PAIN MANAGEMENT PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUK KI KIM MD (PRESIDENT)
(270) 684-5679
Entity
Organization
Contact information
Practice address
3332 VILLA PT STE 104, OWENSBORO, KY 42303-7818
(270) 684-5679
(270) 684-5753
Mailing address
3332 VILLA PT, SUITE 104, OWENSBORO, KY 42303-7818
(270) 684-5679
(270) 684-5753
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200426500A
—
IN
05
—
64177280
—
KY
Enumeration date
11/02/2006
Last updated
04/12/2018
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