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General NPI Number Information
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NPI Number | 1942654702
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Entity Type | Individual
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Provider Name | JOYCE KIM MD
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Gender | Female
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Dates
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Enumeration Date | 04/19/2016
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Last Update Date | 07/14/2023
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Provider Practice Location Address
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Address Line | 61 WHITCHER ST NE STE 2100
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City | MARIETTA
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State | GA
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Zip | 30060-1179
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Country | US
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Telephone | 704-230-5957
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Fax |
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Provider Business Mailing Address
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Address Line | 61 WHITCHER ST NE STE 2100
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City | MARIETTA
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State | GA
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Zip | 30060-1179
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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 |
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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 | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 01090632A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 89439
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License Number State | GA
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