Kim, Jong Gu

Kim, Jong Gu is an individual health care provider with primary practice located at 2221 East Prospect , Ashtabula OH 44004. He recently has only one registered license in Allopathic & Osteopathic Physicians / Otolaryngology, which is considered as his primary health care specialty. Kim, Jong Gu can be contacted via phone (440) 997-5781.

Contact Information

Primary practice address
2221 East Prospect Ashtabula OH 44004
Phone: (440) 997-5781
Fax: (440) 997-5725
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Otolaryngology 207Y00000X 35365 Ohio

Profile Details

NPI number 1265449961
LBN Legal business name Kim, Jong Gu
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 2nd, 2006
Last updated Oct 3rd, 2007 - about 17 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1265449961 NPPES
Ohio MEDICAID 0217661

Popular Providers