Provider Demographics
NPI:1083213904
Name:SEO, JIN HYUK (PHARMD)
Entity Type:Individual
Prefix:
First Name:JIN
Middle Name:HYUK
Last Name:SEO
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1751 NEWNAN CROSSING BLVD E
Mailing Address - Street 2:
Mailing Address - City:NEWNAN
Mailing Address - State:GA
Mailing Address - Zip Code:30265-1517
Mailing Address - Country:US
Mailing Address - Phone:678-523-5845
Mailing Address - Fax:678-523-5846
Practice Address - Street 1:1751 NEWNAN CROSSING BLVD E
Practice Address - Street 2:
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30265-1517
Practice Address - Country:US
Practice Address - Phone:678-523-5845
Practice Address - Fax:678-523-5846
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-21
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH0315553336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy