DR. SOO JIN LEE (NPI# 1457702862) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457702862 |
| Entity Type | Individual |
| Full Name | DR. SOO JIN LEE |
| Credential | D.O. |
| Practice Address |
108 Prominence Ct Ste 200 Dawsonville GA 30534 |
| Mailing Address |
Po Box 742616 Atlanta GA 30374-2616 |
| Practice Telephone | 7062163238 |
| Mailing Telephone | 7702198420 |
| Enumeration Date | 2016-06-27 |
| Last Update Date | 2019-06-18 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 83342 | GA | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | LL39374 | SC | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 853 N Church St, Suite 510, Spartanburg, SC 293033098 | 8645606193 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518451103 | Soo Jin Lee | Dentist | 11416 N Fm 620 Rd Ste K, Austin, TX 78726-1165 | 2018-06-18 |
| 1861910267 | Soo Jin Lee | Marriage & Family Therapist | 600 St Paul Ave, Los Angeles, CA 90017-2038 | 2017-09-06 |
| 1598016800 | Soo Jin Lee | Pharmacist | 11845 Carmel Mountain Rd, San Diego, CA 92128-4602 | 2012-09-26 |
| Street Address |
108 PROMINENCE CT STE 200 |
| City | DAWSONVILLE |
| State | GA |
| Zip Code | 30534 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083610711 | Dawn Sosebee | Nurse Practitioner | 108 Prominence Ct Ste 200, Dawsonville, GA 30534-6340 | 2005-06-27 |
| 1821647215 | Katelyn Westbrook Goodwin | Nurse Practitioner | 108 Prominence Ct Ste 200, Dawsonville, GA 30534-6340 | 2019-09-09 |
| 1477038107 | Paige Reece Hood | Nurse Practitioner | 108 Prominence Ct Ste 200, Dawsonville, GA 30534 | 2018-09-28 |
| 1699120964 | John Travis Nelson | Family Medicine | 108 Prominence Ct Ste 200, Dawsonville, GA 30534-6340 | 2016-04-25 |
| 1700264728 | Trey Gunter | Family Medicine | 108 Prominence Ct Ste 200, Dawsonville, GA 30534 | 2015-05-11 |
| 1164522330 | George Joseph Petro Jr. | Internal Medicine | 108 Prominence Ct Ste 200, Dawsonville, GA 30534-6340 | 2006-09-25 |
| 1528040458 | William Angelo Primos Jr. | Pediatrics | 108 Prominence Ct Ste 200, Dawsonville, GA 30534-6340 | 2005-11-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780175331 | Sharon Redd | Occupational Therapist | 923 Riverbend Rd, Dawsonville, GA 30534 | 2018-05-18 |
| 1588103808 | Hearing Aid Solutions LLC | Hearing Instrument Specialist | 169 Hwy 9, Suite 100, Dawsonville, GA 30534 | 2017-02-20 |
| 1881140598 | Meagan Wilson | Registered Nurse | 6002 Ga 53, Suite 100, Dawsonville, GA 30534 | 2016-09-01 |
| 1265892293 | Interventional Spine and Pain Management Center, PC | Pain Medicine | 6002 Hwy 52 East, Suite 110, Dawsonville, GA 30534 | 2016-03-03 |
| 1174961304 | Meredith Michelle Tatum Hulsey | Physician Assistant | 1080 Lumpkin Campground Road S, Suite 300, Dawsonville, GA 30534 | 2013-06-10 |
| 1932467115 | David Kenneth Woolsey | Chiropractor | 1100 Old Dawson Village Rd, Suite 010, Dawsonville, GA 30534 | 2012-04-25 |
| 1275836769 | Martha Leslie Baker | Counselor | 121 Old Dawson Village Rd E, Building 800, Unit 010, Dawsonville, GA 30534 | 2010-12-06 |
| 1982914073 | James Paul Whitcomb | Pharmacist | 751 Highway 53 East Fred's #1451, Dawsonville, GA 30534 | 2010-10-07 |
| 1801123302 | Sj&j Spine and Pain Group | Pain Medicine | 5959 Highway 53 W, Suite 100b, Dawsonville, GA 30534 | 2009-11-04 |
| 1215260617 | Durall Capital Holdings, LLC | Clinic/Center | 35 Lumpkin Campground Road N, Dawsonville, GA 30534 | 2009-09-16 |
| Find all providers in zip 30534 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215579321 | Nabil Keith Md LLC | Family Medicine | 6002 Highway 53 E Ste 130, Dawsonville, GA 30534-6227 | 2019-10-09 |
| 1023545431 | John Tyler Andrews | Family Medicine | 108 Prominence Ct Ste 100, Dawsonville, GA 30534-6340 | 2017-05-16 |
| 1669860334 | Ghosn Family Medicine | Family Medicine | 6002 Highway 53 E Ste 100, Dawsonville, GA 30534-6227 | 2015-01-05 |
| 1437496866 | Rocco John Vitacca | Family Medicine | 506 River Sound Ln, Dawsonville, GA 30534-0727 | 2013-01-04 |
| 1518278829 | Cymanthia Keesha Connell | Family Medicine | 81 Northside Dawson Dr Ste 100a, Dawsonville, GA 30534-7166 | 2010-07-01 |
| 1609039668 | Katherine Jane Tolhurst | Family Medicine | 45 Medical Center Dr, Dawsonville, GA 30534-6297 | 2008-07-09 |
| 1164564910 | Gary C Berliner | Family Medicine | 2395 Thompson Rd, Dawsonville, GA 30534-5376 | 2007-02-12 |
| 1104975002 | William Joseph Keating | Family Medicine | 1080 Lumpkin Campground Rd S, Suite 300, Dawsonville, GA 30534-0989 | 2007-01-09 |
| 1407943301 | Ramzi Nabih Ghosn | Family Medicine | 6002 Highway 53 E, Suite 100, Dawsonville, GA 30534-6227 | 2006-10-10 |
| 1467437913 | Lawrence F Kulish | Family Medicine | 35 Lumpkin Campground Rd N, Dawsonville, GA 30534-6206 | 2005-12-07 |
| Find all providers in DAWSONVILLE | ||||
| City | DAWSONVILLE |
| Zip Code | 30534 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.