Individual
JESSICA VIVIAN KANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
6602 WATERS AVE, BLDG A, SAVANNAH, GA 31406-2758
(912) 350-6000
(912) 350-6001
Mailing address
6602 WATERS AVE BLDG A, SAVANNAH, GA 31406-2778
(912) 350-6000
(912) 350-6001
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
068266
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003127368B
—
GA
05
—
PENDING
—
GA
Enumeration date
05/08/2009
Last updated
02/10/2022
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