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Individual

DR. JEONG HUN PAIK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
200 DOCTORS DR STE K, DOUGLAS, GA 31533-2202
(912) 384-4024
(912) 384-4040
Mailing address
PO BOX 1377, DOUGLAS, GA 31534
(912) 384-1477
(912) 384-1470

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
061310
GA
207R00000X
Internal Medicine Physician
Primary
61310
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11D1098856
CLIA ID
GA
01
205778734007
TRICARE SOUTH REGION
GA
01
498159
WELLCARE
GA
01
61310
PHYSICIAN LICENSE #
GA
05
871249394A
GA
01
DH1281
RAILROAD MEDICARE - GROUP #
GA
01
P00787894
RAILROAD MEDICARE - PTAN
GA
Enumeration date
07/14/2008
Last updated
03/07/2023
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