Provider Demographics
NPI:1407487614
Name:AN KIL, SOOK SUNG
Entity type:Individual
Prefix:
First Name:SOOK SUNG
Middle Name:
Last Name:AN KIL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5805 SUGARLOAF PKWY UNIT 1214
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30043-6568
Mailing Address - Country:US
Mailing Address - Phone:404-645-2005
Mailing Address - Fax:
Practice Address - Street 1:2148 DULUTH HWY STE 110
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30097-4504
Practice Address - Country:US
Practice Address - Phone:404-645-2005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-28
Last Update Date:2025-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist