MEDICARE: JUNG BUM KIM D.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	171100000X	Acupuncturist	LIC562	GA
2	111N00000X	Chiropractor	7922	GA

General Provider Information

NPI Number	:	1265648539
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUNG BUM KIM D.C

Provider Business Mailing Address
First Line	:	3775 VENTURE DR STE 101
Second Line	:
City	:	DULUTH
State	:	GA
Zip	:	30096-5102
Country	:	US
Telephone Number	:	770-817-9608
Fax Number	:	770-817-9610

Provider Business Practice Location Address
First Line	:	3775 VENTURE DR BLDG N
Second Line	:	STE 101
City	:	DULUTH
State	:	GA
Zip	:	30096-5102
Country	:	US
Telephone Number	:	770-817-9608
Fax Number	:	770-817-9610

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

Provider Enumeration Date	:	05/15/2007
Last Update Date	:	01/08/2026

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