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General NPI Number Information
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NPI Number | 1912422726
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Entity Type | Organization
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Legal Business Name | YES MEDICAL CENTER LLC
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Dates
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Enumeration Date | 08/14/2017
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Last Update Date | 08/14/2017
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Provider Practice Location Address
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Address Line | 2005 BOGGS RD STE 104
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City | DULUTH
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State | GA
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Zip | 30096-4602
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Country | US
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Telephone | 770-497-0882
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Fax | 770-497-0861
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Provider Business Mailing Address
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Address Line | 2005 BOGGS RD STE 104
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City | DULUTH
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State | GA
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Zip | 30096-4602
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DR. JOSEPH KIM
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Credential |
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Telephone | 770-497-0882
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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