Provider Demographics
NPI:1972892388
Name:LEE, JOHN YONGSEUNG (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:YONGSEUNG
Last Name:LEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:119 VINCA CIR
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-4440
Mailing Address - Country:US
Mailing Address - Phone:470-755-7740
Mailing Address - Fax:678-854-8008
Practice Address - Street 1:1325 SATELLITE BLVD NW BLDG 700
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-4651
Practice Address - Country:US
Practice Address - Phone:678-417-1255
Practice Address - Fax:678-417-1258
Is Sole Proprietor?:No
Enumeration Date:2011-04-06
Last Update Date:2017-02-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA74026207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics