Provider Demographics
NPI:1023264231
Name:JIN, ERICA (DO)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:JIN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 116156
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30368-6156
Mailing Address - Country:US
Mailing Address - Phone:678-312-5525
Mailing Address - Fax:770-339-2120
Practice Address - Street 1:1942 ATKINSON RD
Practice Address - Street 2:SUITE 100
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30043-5004
Practice Address - Country:US
Practice Address - Phone:678-775-0600
Practice Address - Fax:678-377-5284
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-07
Last Update Date:2020-09-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA64396207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology