Keonho Kong MD
Otolaryngology Physician in Jackson, MS(View on Map)
Full Name
Keonho Kong MD
NPI Number
1871988915
NPI Type
Individual Provider
Gender
Male
Enumeration Date
04/06/2015
Specialties
(Taxonomies)Code
207Y00000X
390200000X
Primary Taxonomy
Yes
No
Licenses
State
Mississippi
North Carolina
License Number
30284
2021-01892
Contact
Information
Purpose
Mailing
Location
Address
504 CLINTON CENTER DR STE 4300
2500 N STATE ST
City
Clinton
Jackson
State
MS
MS
Postal Code
39056-5610
39216-4500
Country
US
US
Telephone Number
(601) 815-2005
(601) 815-2005
Health Information Exchange
Endpoint Type
DIRECT
Endpoint
KKONG706786@DIRECT.UNC.NCHIE.NET
Endpoint Description
Unknown
Use
Direct
Content Type
Other
Other Description:CDA/CCD/TXT
Affiliation
N
Endpoint Location
2226 Nelson Hwy Ste 101Chapel Hill, NC275179638US
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 08/31/2022
Provider Address
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