1265481261 NPI number — DR. STEVE C. KIM D.C.

Table of content: DR. STEVE C. KIM D.C. (NPI 1265481261)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265481261 NPI number — DR. STEVE C. KIM D.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KIM
Provider First Name:
STEVE
Provider Middle Name:
C.
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.C.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1265481261
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/13/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
615 BAKERS BRIDGE AVENUE
Provider Second Line Business Mailing Address:
SUITE NUMBER 120
Provider Business Mailing Address City Name:
FRANKLIN
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37067-1687
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-764-0001
Provider Business Mailing Address Fax Number:
615-764-0002

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
615 BAKERS BRIDGE AVENUE
Provider Second Line Business Practice Location Address:
SUITE NUMBER 120
Provider Business Practice Location Address City Name:
FRANKLIN
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37067-1687
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
615-764-0001
Provider Business Practice Location Address Fax Number:
615-764-0002
Provider Enumeration Date:
05/08/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  2101 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 4120860 . This is a "BLUECARE" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 696690 . This is a "ACN" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 4120860 . This is a "BCBS" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 4120860 . This is a "BLUESELECT" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 696690 . This is a "GE WELLNESS PLAN" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 4120860 . This is a "BLUECLASSIC" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 696690 . This is a "GREAT-WEST HEALTHCARE" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 696690 . This is a "BLUEGRASS FAMILY HEALTH" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 696690 . This is a "HEALTH ALLIES" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 696690 . This is a "GOLDEN RULE" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 696690 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 4120860 . This is a "BLUEPREFERRED" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".




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