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NPI Code Detail

MEDICARE: JOHN D. KIM PC

MEDICARE: JOHN D. KIM PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111NX0800XOrthopedic ChiropractorCHIR008162GA
2111NR0400XRehabilitation ChiropractorCHIR008162GA
3111NN1001XNutrition ChiropractorCHIR008162GA
4261QR0400XRehabilitation Clinic/CenterCHIR008162GA

General Provider Information

NPI Number : 1033404066
Entity Type Code : Organization
Provider Name (Legal Business Name) : JOHN D. KIM PC
Provider Business Mailing Address
First Line : 1299 OLD PEACHTREE RD NW
Second Line : SUITE # 101
City : SUWANEE
State : GA
Zip : 30024-2028
Country : US
Telephone Number : 770-882-6666
Fax Number : 770-252-6800
Provider Business Practice Location Address
First Line : 1299 OLD PEACHTREE RD NW
Second Line : SUITE # 101
City : SUWANEE
State : GA
Zip : 30024-2028
Country : US
Telephone Number : 770-882-6666
Fax Number : 770-252-6800
Authorized Official
Title or Position : OWNER
Name : DR. DO YOUNG KIM
Credential : D.C.
Telephone Number : 770-882-6666
Provider Enumeration Date : 06/17/2011
Last Update Date : 06/21/2011

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