Provider Demographics
NPI:1780641266
Name:HUCH, KIM M (MD)
Entity Type:Individual
Prefix:DR
First Name:KIM
Middle Name:M
Last Name:HUCH
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:66 N PAULINE ST
Mailing Address - Street 2:SUITE 206
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38105-5105
Mailing Address - Country:US
Mailing Address - Phone:901-448-7642
Mailing Address - Fax:901-448-8015
Practice Address - Street 1:1910 NONCONNAH BLVD
Practice Address - Street 2:SUITE 120
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38132-2113
Practice Address - Country:US
Practice Address - Phone:901-448-2300
Practice Address - Fax:901-448-6657
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-27
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TN21524207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3076958Medicaid
3076951Medicare ID - Type Unspecified
F62663Medicare UPIN