Organization
FAMILY MEDICINE OF GWINNETT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. YONG S KIM MD (DOCTOR/OWNER)
(770) 638-1401
Entity
Organization
Contact information
Practice address
1742 OAK ROAD, SNELLVILLE, GA 30078
(770) 638-1401
(770) 638-1402
Mailing address
1742 OAK ROAD, SNELLVILLE, GA 30078
(770) 638-1401
(770) 638-1402
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
046142
GA
302F00000X
Exclusive Provider Organization
046142
GA
302R00000X
Health Maintenance Organization
046142
GA
Other
Enumeration date
06/18/2009
Last updated
06/18/2009
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