| Doctor Name: | JEFFREY L KIM |
| NPI Number: | 1275506560 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 056117 |
| Business Practice Address: | 1700 Hospital South Dr Suite 410 Austell, GA - 301066810 |
| Business Phone Number: | 7707399555 |
| Business Fax Number: | 7707328110 |
| Mailing Address: | 711 Canton Rd Ne, Suite 300 MARIETTA |
| State: | GA |
| Postal Code: | 300608948 |
| Phone Number: | 6787415000 |
| Fax Number: | 6788194280 |
| NPI Enumeration Date: | 02/08/2006 |
| NPI Last Update Date: | 05/11/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | 056117 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | GA |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |