Individual
JEONG SOK SEO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6 HOSPITAL PARK, MOULTRIE, GA 31768-6700
(229) 891-9009
(229) 890-1282
Mailing address
PO BOX 2438, MOULTRIE, GA 31776-2438
(229) 891-9009
(229) 890-1282
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
65307
GA
208M00000X
Hospitalist Physician
065307
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003109900D
—
GA
05
—
003109900E
—
GA
01
—
202I119252
MEDICARE PTAN
GA
Enumeration date
11/09/2007
Last updated
07/21/2022
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