MEDICARE: HANNAH KIM PA-C

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
1	363A00000X	Physician Assistant	11071	GA

General Provider Information

NPI Number	:	1205563442
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HANNAH KIM PA-C

Provider Business Mailing Address
First Line	:	59 TIPTON DR
Second Line	:
City	:	DAHLONEGA
State	:	GA
Zip	:	30533-1603
Country	:	US
Telephone Number	:	770-800-3455
Fax Number	:	770-450-8024

Provider Business Practice Location Address
First Line	:	1521 HICKORY FLAT HWY STE 203
Second Line	:
City	:	CANTON
State	:	GA
Zip	:	30115-3502
Country	:	US
Telephone Number	:	770-800-3455
Fax Number	:	770-450-8024

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/08/2022
Last Update Date	:	12/02/2025

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Directions to “ HANNAH KIM PA-C” Practice Location

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