Kun Zoo Kim, M.D.

Primary specialty

Facial Plastic Surgery PhysicianTaxonomy code 207YS0123X

License

039608 Issued in GA

Practice address

3042 Oakcliff Rd
Suite 200
Doraville, GA 30340-2699

Phone

(770) 458-4255

Fax

(770) 458-4406

NPI assigned

Jul 6, 2005

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• North Atlanta Scan Associates Inc

  • Radiology Clinic/Center
  • Alpharetta, GA
  • NPI 1700826096
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1120608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233100800000",
    "number": "1568469591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3042 OAKCLIFF RD",
            "address_2": "SUITE 200",
            "city": "DORAVILLE",
            "state": "GA",
            "postal_code": "303402699",
            "telephone_number": "770-458-4255",
            "fax_number": "770-458-4406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3042 OAKCLIFF RD",
            "address_2": "SUITE 200",
            "city": "DORAVILLE",
            "state": "GA",
            "postal_code": "303402699",
            "telephone_number": "770-458-4255",
            "fax_number": "770-458-4406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "KUN",
        "middle_name": "ZOO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-06",
        "last_updated": "2009-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "GA",
            "license": "039608",
            "primary": true
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "GA",
            "license": "039608",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "0683598",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "516833",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF GEORGIA",
            "identifier": "52498637",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000670458F",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tangela James, LPN
• Suprabha Jois
• Carl Joyce Jr., LMT
• Kevin Washington
• Kim ENT, P.C.
• Lia Kim
• Meu Keon Kim, LAC
• Krasna Seng Kuoch, D.N., P.M.D (IP) DEM
• Yong Ku Kwon, PA
• Teklewold H Lake, PA-C

• Facial Plastic Surgery Physician in Doraville, GA
• Providers in Doraville, GA by specialty
• Facial Plastic Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.