Dr. Kim'S Adult Clinic, PLLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

200101455 Issued in NC

Legal business name

DR. KIM'S ADULT CLINIC, PLLC

Practice address

8100 Twisted Hickory Rd
Bladenboro, NC 28320-7010

Phone

(910) 876-7301

Fax

(910) 648-5650

NPI assigned

Sep 18, 2017

Organization subpart

No

Name

Dr. Jong Whan Kim, MD

Title

Owner/Provider

Phone

(910) 876-7301

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 21, 2022.

{
    "created_epoch": "1505692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1174042485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8100 TWISTED HICKORY RD",
            "city": "BLADENBORO",
            "state": "NC",
            "postal_code": "283207010",
            "telephone_number": "910-876-7301",
            "fax_number": "910-648-5650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8100 TWISTED HICKORY RD",
            "city": "BLADENBORO",
            "state": "NC",
            "postal_code": "283207010",
            "telephone_number": "910-876-7301",
            "fax_number": "910-648-5650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. KIM'S ADULT CLINIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-18",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "JONG",
        "authorized_official_middle_name": "WHAN",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "910-876-7301",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "NC",
            "license": "200101455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clark, Hays and Associates, PLLC
• Tiffany Anne Clowers, PA-C
• Coastal Southeastern United Care LLC
• Donald Benton Helms
• Michal Paul Dove
• Crystal Edwards, P.A.-C
• Allison Cavenaugh Eggleston, D.D.S., M.S.
• Family Alternatives, Inc
• Fuller & Associates VI PLLC
• Gate Way Health Care Associates LLC

• All providers in Bladenboro, NC
• General Practice Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.