Individual
JEFFREY L KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
118 MILL ST STE 110, WOODSTOCK, GA 30188
(678) 741-5000
(770) 517-5004
Mailing address
711 CANTON RD NE STE 300, MARIETTA, GA 30060-8949
(678) 741-5000
(678) 819-4280
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
056117
GA
207RG0100X
Gastroenterology Physician
Primary
056117
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
247569424B
—
GA
Enumeration date
02/08/2006
Last updated
05/31/2018
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