Provider Demographics
NPI:1306906664
Name:KIM, HAK-JOONG (MD)
Entity type:Individual
Prefix:DR
First Name:HAK-JOONG
Middle Name:
Last Name:KIM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 SHEFFIELD DR
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53005-7926
Mailing Address - Country:US
Mailing Address - Phone:414-321-1900
Mailing Address - Fax:414-321-0089
Practice Address - Street 1:5757 W OKLAHOMA AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53219-4303
Practice Address - Country:US
Practice Address - Phone:414-321-1900
Practice Address - Fax:414-321-0089
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-09
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI20698207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI30147600Medicaid
WIAK5413593OtherDEA NUMBER
WIAK5413593OtherDEA NUMBER
WI019885Medicare ID - Type Unspecified