Provider Demographics
NPI:1346349727
Name:KIM, DANIEL KIHONG (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:KIHONG
Last Name:KIM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:831 RICE RD APT 1104
Mailing Address - Street 2:
Mailing Address - City:RIDGELAND
Mailing Address - State:MS
Mailing Address - Zip Code:39157-3028
Mailing Address - Country:US
Mailing Address - Phone:601-812-9409
Mailing Address - Fax:
Practice Address - Street 1:D KIM, MD OPHTHALMOLOGY
Practice Address - Street 2:314 SGT. S. PRENTISS
Practice Address - City:NATCHEZ
Practice Address - State:MS
Practice Address - Zip Code:39120
Practice Address - Country:US
Practice Address - Phone:601-442-3713
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS17329207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MSBK7802122OtherDEA
MS17329OtherMEDICAL LICENSE