Provider Demographics
NPI:1851355408
Name:KIM, BETTY S (MD)
Entity Type:Individual
Prefix:
First Name:BETTY
Middle Name:S
Last Name:KIM
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:2222 N NEVADA AVE
Mailing Address - Street 2:SUITE 5011
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80907-6819
Mailing Address - Country:US
Mailing Address - Phone:719-776-7600
Mailing Address - Fax:719-473-3553
Practice Address - Street 1:2222 N NEVADA AVE
Practice Address - Street 2:SUITE 5011
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-6819
Practice Address - Country:US
Practice Address - Phone:719-776-7600
Practice Address - Fax:719-473-3553
Is Sole Proprietor?:No
Enumeration Date:2006-04-12
Last Update Date:2013-09-11
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Provider Licenses
StateLicense IDTaxonomies
MA224350208G00000X
TN42202208G00000X
NC2011-00040208G00000X
CO52412208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)