Kim, Dae Y

Kim, Dae Y is an individual health care provider with primary practice located at 1145 S Utica Ave Suite 202, Tulsa OK 74104-4000. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Kim, Dae Y can be contacted via phone (918) 579-3130.

Contact Information

Primary practice address
1145 S Utica Ave Suite 202 Tulsa OK 74104-4000
Phone: (918) 579-3130
Fax: (918) 579-3139
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Urology 208800000X 31577 Oklahoma

Profile Details

NPI number 1003000597
LBN Legal business name Kim, Dae Y
Credentials M.D., PH.D
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 28th, 2007
Last updated Jul 15th, 2015 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1003000597 NPPES
Texas MEDICAID 324649801 (MDACC)
Texas Other 8EB319 (MDACC)

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