John Marion Kim (NPI# 1891731204, PAC ID# 1052504149) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is MAXILLOFACIAL SURGERY.
| Nation Provider ID (NPI) | 1891731204 |
| PAC ID by PECOS | 1052504149 |
| Professional Enrollment ID | I20101021000619 |
| Full Name | John Marion Kim |
| Address |
3102 Niles Rd Saint Joseph MI 49085-8609 |
| Gender | M |
| Medical School | WASHINGTON UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 1984 |
| Primary Specialty | MAXILLOFACIAL SURGERY |
| Secondary Specialties | ORAL SURGERY |
| Accepts Medicare Assignment | M |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 230021 | LAKELAND HOSPITAL, ST JOSEPH |
| Address | Phone | Organization |
|---|---|---|
| 3102 Niles Rd, Saint Joseph, MI 49085-8609 |
| Street Address |
3102 NILES RD |
| City | SAINT JOSEPH |
| State | MI |
| Zip | 49085-8609 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Andrew Paul Bringard | Optometry | Rx Optical Laboratories, Inc. | 2008 Washington, St Joseph, MI 49085 |
| Heather L Cotter | Optometry | Rx Optical Laboratories, Inc. | 2008 Washington, St Joseph, MI 49085 |
| Bruce P Hackworth | Psychologist, Clinical | 811 Ship St, 4b, Saint Joseph, MI 49085-1171 | |
| Thomas E Wilson | Chiropractic | Hudak Chiropractic Clinic PC | 804 Elm St, St Joseph, MI 49085-1227 |
| Erik T Hudak | Chiropractic | Hudak Chiropractic Clinic PC | 804 Elm St, St Joseph, MI 49085-1227 |
| Heather M Hudak | Chiropractic | Hudak Chiropractic Clinic PC | 804 Elm St, St Joseph, MI 49085-1227 |
| Gary Paul Ludwig | Optometry | 1101 Main St, Saint Joseph, MI 49085-1509 | |
| Janel L Benore | Physical Therapy | 616 Main St, Saint Joseph, MI 49085-1595 | |
| Susan L Startup | Clinical Social Worker | 1901 Niles Ave, Suite 102, Saint Joseph, MI 49085-1615 | |
| Craig F Sherwood | Podiatry | 1901 Niles Ave, Saint Joseph, MI 49085-1615 | |
| Find all physicians in zip 49085 | |||
| City | SAINT JOSEPH |
| Zip Code | 49085 |
| Specialty | MAXILLOFACIAL SURGERY |
| City + Specialty | SAINT JOSEPH + MAXILLOFACIAL SURGERY |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.