Individual
JIN LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
500 MEDICAL CENTER BLVD STE 310, LAWRENCEVILLE, GA 30046-3332
(678) 312-0450
(678) 312-0440
Mailing address
1550 COLLEGE ST, MACON, GA 31207-1500
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
819176
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/24/2016
Last updated
07/31/2019
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