MEDICARE: JENNA MAY KIM MD

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	207WX0200X	Ophthalmic Plastic and Reconstructive Surgery Physician	96077	GA

General Provider Information

NPI Number	:	1184037129
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNA MAY KIM MD

Provider Business Mailing Address
First Line	:	3890 JOHNS CREEK PKWY STE 245
Second Line	:
City	:	SUWANEE
State	:	GA
Zip	:	30024-6697
Country	:	US
Telephone Number	:	770-604-4141
Fax Number	:	770-604-4140

Provider Business Practice Location Address
First Line	:	3890 JOHNS CREEK PKWY STE 240
Second Line	:
City	:	SUWANEE
State	:	GA
Zip	:	30024-1286
Country	:	US
Telephone Number	:	770-604-4141
Fax Number	:	770-604-4140

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

Provider Enumeration Date	:	06/07/2014
Last Update Date	:	01/02/2026

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Directions to “ JENNA MAY KIM MD” Practice Location

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