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Organization
MK PODIATRY LLC
Active
Organization
MK PODIATRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MI KIM DPM (OWNER)
(404) 291-6473
Entity
Organization
Contact information
Practice address
1790 ATKINSON RD STE D200, LAWRENCEVILLE, GA 30043-7991
(404) 291-6473
Mailing address
1790 ATKINSON RD STE D200, LAWRENCEVILLE, GA 30043-7991
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
POD001300
GA
Other
Enumeration date
07/18/2016
Last updated
07/18/2016
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