| Jk Internal Medicine & Geriatrics,pc | |
|
1325 Satellite Blvd Bldg 700 Ste 701a Suwanee GA 30024-4651 | |
| (678) 417-1255 | |
| (678) 417-1258 |
| Full Name | Jk Internal Medicine & Geriatrics,pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1325 Satellite Blvd, Suwanee, Georgia |
| Authorized Official Name and Position | Jinahn Kim (PRESIDENT) |
| Authorized Official Contact | 6784171255 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jk Internal Medicine & Geriatrics,pc 1325 Satellite Blvd, Bldg 700 Ste 701a Suwanee GA 30024-4651 Ph: (678) 417-1255 | Jk Internal Medicine & Geriatrics,pc 1325 Satellite Blvd Bldg 700 Ste 701a Suwanee GA 30024-4651 Ph: (678) 417-1255 |
| NPI Number | 1649460437 |
|---|---|
| Provider Enumeration Date | 07/27/2007 |
| Last Update Date | 08/17/2011 |
| Medicare PECOS PAC ID | 1951480839 |
|---|---|
| Medicare Enrollment ID | O20080502000571 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649460437 | NPI | - | NPPES |
| 488455065A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 59806 (Georgia) | Secondary |
| 207R00000X | Internal Medicine | 54442 (Georgia) | Primary |
| Provider Name | Jinahn E Kim |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922057702 PECOS PAC ID: 6709865272 Enrollment ID: I20040917000542 |
| Provider Name | Jaeyoung Lee |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427499615 PECOS PAC ID: 1153550959 Enrollment ID: I20200514002683 |
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