K. Kwang Soo, M.D., S.C.

LBN: K. Kwang Soo, M.D., S.C.
K. Kwang Soo, M.D., S.C. is an health care organization with primary practice located at 2691 N Lake Dr , Milwaukee WI 53211-3838. The organization recently has only one registered license in Ambulatory Health Care Facilities / Adult Mental Health, which is considered as the primary health care specialty. K. Kwang Soo, M.D., S.C. can be contacted via phone (414) 228-8300, or through Soo, Kam Kwang via phone (414) 964-6077.

Contact Information

Primary practice address
2691 N Lake Dr Milwaukee WI 53211-3838
Phone: (414) 228-8300
Fax: (414) 228-6303
Website:
Map and Directions
Authorized official contact:
Name: Soo, Kam Kwang Doctor of Medicine (MD)
Phone: (414) 964-6077

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Adult Mental Health 261QM0850X 19331 Wisconsin

Profile Details

NPI number 1336296722
LBN Legal business name K. Kwang Soo, M.D., S.C.
DBA Doing business as
Authorized official Soo, Kam Kwang Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Jan 5th, 2007
Last updated Aug 22nd, 2020 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1336296722 NPPES
Wisconsin MEDICAID 301 529 00

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