Kim, Jason K

Kim, Jason K is an individual health care provider with primary practice located at 4414 Lake Boone Trl , Raleigh NC 27607-7513. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Vascular Surgery. Allopathic & Osteopathic Physicians / Vascular Surgery is his primary health care specialty. Kim, Jason K can be contacted via phone (919) 784-2300.

Contact Information

Primary practice address
4414 Lake Boone Trl Raleigh NC 27607-7513
Fax: (919) 784-2301
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 2012-02076 North Carolina
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X 252638 New York
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X 2012-02076 North Carolina

Profile Details

NPI number 1376733873
LBN Legal business name Kim, Jason K
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 31st, 2007
Last updated Apr 1st, 2021 - 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 1376733873 NPPES
Louisiana MEDICAID 1050075

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