Kim, Jennifer Lee

Kim, Jennifer Lee is an individual health care provider with primary practice located at 1000 Corporate Center Dr Suite 100, Morrow GA 30260-4180. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Ophthalmology. Allopathic & Osteopathic Physicians / Ophthalmology is her primary health care specialty. Kim, Jennifer Lee can be contacted via phone (770) 968-8888.

Contact Information

Primary practice address
1000 Corporate Center Dr Suite 100 Morrow GA 30260-4180
Phone: (770) 968-8888
Fax: (770) 960-2473
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 074038 Georgia
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 38366 South Carolina

Profile Details

NPI number 1811286149
LBN Legal business name Kim, Jennifer Lee
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 7th, 2011
Last updated Dec 11th, 2018 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1811286149 NPPES
Other 581787543 EYE CARE CENTERS MANAGEMENT, INC. D/B/A CLAYTON EYE CENTER
MEDICAID 003181756A EYE CARE CENTERS MANAGEMENT, INC. D/B/A CLAYTON EYE CENTER

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