# FAMILY MEDICINE OF GWINNETT, LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255568150
- **Authorized official:** DR. YONG S KIM MD (DOCTOR/OWNER)
- **Authorized official phone:** (770) 638-1401

## Contact information

- **Practice address:** 1742 OAK ROAD, SNELLVILLE, GA 30078
- **Practice address phone:** (770) 638-1401
- **Practice address fax:** (770) 638-1402
- **Mailing address:** 1742 OAK ROAD, SNELLVILLE, GA 30078
- **Mailing address phone:** (770) 638-1401
- **Mailing address fax:** (770) 638-1402

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251K00000X | Public Health or Welfare Agency | 046142 | GA | Yes |
| 302F00000X | Exclusive Provider Organization | 046142 | GA | — |
| 302R00000X | Health Maintenance Organization | 046142 | GA | — |

## Other

- **Enumeration date:** 06/18/2009
- **Last updated:** 06/18/2009