JAE KIM MD PLC NPI 1306308382

NPI Information

NPI: 1306308382
Provider Name: JAE KIM, MD PLC
Classification: Otolaryngology - 207YS0123X
Entity Type: Organization

Specialization: Facial Plastic Surgery

Address:
10721 MAIN ST STE 205
FAIRFAX, VA
ZIP 22030
Phone: (703) 705-2100
Get Directions

JAE KIM, MD PLC is a facial plastic surgery otolaryngology in Fairfax, VA. The provider is an otolaryngologist who specializes in facial plastic surgery. JAE KIM, MD PLC NPI is 1306308382. The provider is registered as an organization entity type.

The provider's business location address is:

10721 MAIN ST STE 205
FAIRFAX, VA
ZIP 22030-902
Phone: (703) 705-2100
Fax: (703) 935-0330

The provider's authorized official is Jae Kim .
The authorized official title is Authorized Member and has the following contact phone number (347) 551-1113.

The enumeration date for this NPI number is 4/1/2019 and was last updated on 6/11/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM2500X	Clinic/Center	Medical Specialty			No
2	207YS0123X	Otolaryngology	Facial Plastic Surgery			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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