Provider Demographics
NPI:1285945295
Name:KO, BYUNGSOO (MD)
Entity type:Individual
Prefix:
First Name:BYUNGSOO
Middle Name:
Last Name:KO
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2121 WARM SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31904-7955
Mailing Address - Country:US
Mailing Address - Phone:706-243-4500
Mailing Address - Fax:706-243-4503
Practice Address - Street 1:2121 WARM SPRINGS RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904-7955
Practice Address - Country:US
Practice Address - Phone:706-243-4500
Practice Address - Fax:706-243-4503
Is Sole Proprietor?:No
Enumeration Date:2010-06-24
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2020025851207RI0011X
KS0439466207RI0011X
TXV1515207RI0011X
GA102812207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology