Provider Demographics
NPI:1376736355
Name:CHONG, KYE IM (MD)
Entity Type:Individual
Prefix:DR
First Name:KYE
Middle Name:IM
Last Name:CHONG
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:PO BOX 746638
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-6638
Mailing Address - Country:US
Mailing Address - Phone:904-202-1032
Mailing Address - Fax:904-376-4107
Practice Address - Street 1:230 VILLAGE COMMONS DRIVE
Practice Address - Street 2:
Practice Address - City:ST. AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32092
Practice Address - Country:US
Practice Address - Phone:904-940-1441
Practice Address - Fax:904-390-7463
Is Sole Proprietor?:No
Enumeration Date:2007-08-22
Last Update Date:2023-05-25
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Provider Licenses
StateLicense IDTaxonomies
GA001929207Q00000X
FLME106337207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine