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General NPI Number Information
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NPI Number | 1124773411
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Entity Type | Individual
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Provider Name | PAUL KWON PHARMD
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Gender | Male
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Dates
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Enumeration Date | 02/16/2022
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Last Update Date | 02/16/2022
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Provider Practice Location Address
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Address Line | 8725 ROSWELL RD STE G
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City | SANDY SPRINGS
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State | GA
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Zip | 30350-7500
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Country | US
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Telephone | 770-640-5956
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Fax |
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Provider Business Mailing Address
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Address Line | 6340 BARWICK LN
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City | DULUTH
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State | GA
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Zip | 30097-7199
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Country | US
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Telephone | 770-880-8648
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RPH032703
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License Number State | GA
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