Healthcare Provider Details

I. General information

NPI: 1962829309
Provider Name (Legal Business Name): JUN KIM M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2014
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 PEACHTREE RD NE STE 575
ATLANTA GA
30309-1476
US

IV. Provider business mailing address

17 E 102ND ST 7TH FLOOR #1087
NEW YORK NY
10029-5204
US

V. Phone/Fax

Practice location:
  • Phone: 404-350-0106
  • Fax:
Mailing address:
  • Phone: 212-659-8551
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number110940
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number297159
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: