Provider Demographics
NPI:1790862225
Name:KIM, PAUL SUGYOON (DO)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:SUGYOON
Last Name:KIM
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10525 N GARFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64155-3272
Mailing Address - Country:US
Mailing Address - Phone:816-838-4662
Mailing Address - Fax:
Practice Address - Street 1:800 W 47TH ST
Practice Address - Street 2:SUITE 630
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64112-1251
Practice Address - Country:US
Practice Address - Phone:816-931-9932
Practice Address - Fax:816-561-5352
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20080211382084P0800X
KS05-331922084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry