Doctor Name: | JUNG S KIM |
NPI Number: | 1689798472 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | R7E16 |
Business Practice Address: | 2821 N Ballas Rd C-30 Saint Louis, MO - 631312321 |
Business Phone Number: | 3145677765 |
Business Fax Number: | |
Mailing Address: | 802 Bluespring Ln, SAINT LOUIS |
State: | MO |
Postal Code: | 631312614 |
Phone Number: | 3144320643 |
Fax Number: | |
NPI Enumeration Date: | 03/19/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261Q00000X |
License Number: | R7E16 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | |
Taxonomy Definition: | A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |