Provider Demographics
NPI:1316235435
Name:LEE, JI YEON (MD)
Entity type:Individual
Prefix:DR
First Name:JI YEON
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ESTHER
Other - Middle Name:
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3400C OLD MILTON PKWY STE 425
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30005-4438
Mailing Address - Country:US
Mailing Address - Phone:770-343-8760
Mailing Address - Fax:770-664-2101
Practice Address - Street 1:3400C OLD MILTON PKWY STE 425
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30005-4438
Practice Address - Country:US
Practice Address - Phone:770-343-8760
Practice Address - Fax:770-664-2101
Is Sole Proprietor?:No
Enumeration Date:2011-07-11
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125059880207R00000X
GA078673207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003193040CMedicaid
GA003193040BMedicaid
GA003193040AMedicaid