Provider Demographics
NPI:1770708190
Name:J. H. KIM, M.D.,LTD
Entity type:Organization
Organization Name:J. H. KIM, M.D.,LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JE
Authorized Official - Middle Name:HONG
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:724-658-5523
Mailing Address - Street 1:177 ENCLAVE DR
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:PA
Mailing Address - Zip Code:16105-3207
Mailing Address - Country:US
Mailing Address - Phone:724-658-5523
Mailing Address - Fax:724-658-8039
Practice Address - Street 1:177 ENCLAVE DR
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:PA
Practice Address - Zip Code:16105-3207
Practice Address - Country:US
Practice Address - Phone:724-658-5523
Practice Address - Fax:724-658-8039
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAK000400L171100000X
PAMD036380L208100000X
208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
Not Answered208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
Not Answered208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0708203Medicaid
PA0708203Medicaid
KI01307Medicare ID - Type Unspecified