Soo Jin Lee (NPI# 1457702862, PAC ID# 2365730967) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1457702862 |
| PAC ID by PECOS | 2365730967 |
| Professional Enrollment ID | I20190726002853 |
| Full Name | Soo Jin Lee |
| Organization Legal Name | NORTHEAST GEORGIA PHYSICIANS GROUP INC |
| Address |
108 Prominence Ct Suite 200 Dawsonville GA 30534-6340 |
| Phone Number | 7062163238 |
| Gender | F |
| Graduation Year | 2016 |
| Primary Specialty | FAMILY MEDICINE |
| Group Practice PAC ID | 6901898386 |
| Number of Group Practice Members | 418 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 110029 | NORTHEAST GEORGIA MEDICAL CENTER, INC |
| Address | Phone | Organization |
|---|---|---|
| 108 Prominence Ct, Suite 200, Dawsonville, GA 30534-6340 | 7062163238 | NORTHEAST GEORGIA PHYSICIANS GROUP INC |
| Organization Legal Name | NORTHEAST GEORGIA PHYSICIANS GROUP INC |
| Physicians | 403 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Christopher R Huckle | Sports Medicine | Northeast Georgia Physicians Group Inc | 1404 River Pl, Suite 401, Braselton, GA 30517-5600 |
| Cinandra Sweatman | Nurse Practitioner | Northeast Georgia Physicians Group Inc | 200 Wisteria Dr, Gainesville, GA 30501-3827 |
| Jennifer B Cobernus | Family Medicine | Northeast Georgia Physicians Group Inc | 852 Dacula Rd, Dacula, GA 30019-3185 |
| Rishita Patel | Family Medicine | Northeast Georgia Physicians Group Inc | 2825 Keith Bridge Rd, Suite 100, Cumming, GA 30041-4304 |
| Lorraine Laura Laplace | Nurse Practitioner | Northeast Georgia Physicians Group Inc | 3575 Braselton Hwy, Dacula, GA 30019-1027 |
| Christopher William Soika | General Surgery | Northeast Georgia Physicians Group Inc | 1400 River Pl, Braselton, GA 30517-5600 |
| Shaakira A Ford | Clinical Social Worker | Northeast Georgia Physicians Group Inc | 4919 Atlanta Hwy, Flowery Branch, GA 30542-3328 |
| Ehren M Gleckler | Nurse Practitioner | Northeast Georgia Physicians Group Inc | 12 7th St, Auburn, GA 30011-3202 |
| James Gregory Hamilton Iii | Family Medicine | Northeast Georgia Physicians Group Inc | 95 Morrison Moore Pkwy W, Dahlonega, GA 30533-1588 |
| Brandi Michelle Ricks | Nurse Practitioner | Northeast Georgia Physicians Group Inc | 3931 Mundy Mill Rd A, Oakwood, GA 30566-3431 |
| Street Address |
108 PROMINENCE CT SUITE 200 |
| City | DAWSONVILLE |
| State | GA |
| Zip | 30534-6340 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Johan Koo | Family Medicine | Northeast Georgia Physicians Group-urgent Care | 108 Prominence Ct, Suite 100, Dawsonville, GA 30534-6340 |
| George J Petro | Internal Medicine | Northeast Georgia Physicians Group Inc | 108 Prominence Ct, Suite 200, Dawsonville, GA 30534-6340 |
| Trinell N Robertson | Nurse Practitioner | Northeast Georgia Physicians Group-urgent Care | 108 Prominence Ct, Suite 100, Dawsonville, GA 30534-6340 |
| Paige Reece Hood | Nurse Practitioner | Northeast Georgia Physicians Group Inc | 108 Prominence Ct, Suite 200, Dawsonville, GA 30534-6340 |
| Trey A Gunter | Family Medicine | Northeast Georgia Physicians Group Inc | 108 Prominence Ct, Suite 200, Dawsonville, GA 30534-6340 |
| Paul J Behrmann | Internal Medicine | Northeast Georgia Physicians Group Inc | 108 Prominence Ct, Suite 200, Dawsonville, GA 30534-6340 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Nabil Keith | Family Medicine | Ghosn Family Medicine | 6002 Hwy 53 E, Suite 100, Dawsonville, GA 30534 |
| Torre S Massey | Nurse Practitioner | Interventional Spine and Pain Management Center, PC | 6002 Hwy 53 E 110, Dawsonville, GA 30534 |
| Ramzi N Ghosn | Family Medicine | Ghosn Family Medicine | 6002 Hwy 53 E, Suite 100, Dawsonville, GA 30534 |
| Timothy A Annis | Chiropractic | 66 S 400 Ctr Ln, Suite 105, Dawsonville, GA 30534-0607 | |
| Harleen Singh | Family Medicine | Dawsonville Family Medicine | 1080 Lumpkin Campground S Rd, Suite 300, Dawsonville, GA 30534-0989 |
| William J Keating | Family Medicine | Dawsonville Family Medicine | 1080 Lumpkin Campground S Rd, Suite 300, Dawsonville, GA 30534-0989 |
| Austin Reid Shelnutt | Physical Therapy | Independent Physical Therapy of Georgia, LLC | 78 Dawson Village Way N, Suite 230, Dawsonville, GA 30534-5642 |
| Charlotte Holt Baird | Physical Therapy | Independent Physical Therapy of Georgia, LLC | 78 Dawson Village Way N, Suite 230, Dawsonville, GA 30534-5642 |
| Andrew Jonathan Sigers Jones | Physical Therapy | Independent Physical Therapy of Georgia, LLC | 78 Dawson Village Way N, Suite 230, Dawsonville, GA 30534-5642 |
| David Meuesen | Physical Therapy | Independent Physical Therapy of Georgia, LLC | 78 Dawson Village Way N, Suite 230, Dawsonville, GA 30534-5642 |
| Find all physicians in zip 30534 | |||
| City | DAWSONVILLE |
| Zip Code | 30534 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | DAWSONVILLE + FAMILY MEDICINE |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.