Kim, James D

Kim, James D is an individual health care provider with primary practice located at 7802 W Jefferson Blvd Ste A , Fort Wayne IN 46804-4138. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Kim, James D can be contacted via phone (260) 305-2822.

Contact Information

Primary practice address
7802 W Jefferson Blvd Ste A Fort Wayne IN 46804-4138
Phone: (260) 305-2822
Fax: (260) 305-2829
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 62214-20 Wisconsin
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 01083315A Indiana

Profile Details

NPI number 1255657151
LBN Legal business name Kim, James D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 16th, 2010
Last updated Aug 5th, 2022 - about 3 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 1255657151 NPPES
Indiana MEDICAID 300058132
Indiana MEDICAID 7100053130

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