Provider Demographics
NPI:1235238775
Name:LIM, ESTEBAN LIM JR (MD)
Entity Type:Individual
Prefix:
First Name:ESTEBAN
Middle Name:LIM
Last Name:LIM
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:223 THORNCREST DR
Mailing Address - Street 2:
Mailing Address - City:RINGGOLD
Mailing Address - State:GA
Mailing Address - Zip Code:30736-2677
Mailing Address - Country:US
Mailing Address - Phone:706-638-5584
Mailing Address - Fax:706-638-5585
Practice Address - Street 1:700 CITY HALL DR
Practice Address - Street 2:
Practice Address - City:FORT OGLETHORPE
Practice Address - State:GA
Practice Address - Zip Code:30742-7802
Practice Address - Country:US
Practice Address - Phone:706-638-5584
Practice Address - Fax:706-638-5585
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA393942084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry