Provider Demographics
NPI:1629268776
Name:OUGH, JASON KIM (MD)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:KIM
Last Name:OUGH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 158
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10150-0158
Mailing Address - Country:US
Mailing Address - Phone:646-558-3613
Mailing Address - Fax:716-242-1912
Practice Address - Street 1:227 E 56TH ST
Practice Address - Street 2:SUITE 203
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-3754
Practice Address - Country:US
Practice Address - Phone:646-558-3613
Practice Address - Fax:716-242-1912
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-25
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY250613207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine