Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207N00000X | Dermatologist | 202777 | LA |
N | 207N00000X | Dermatologist | MD.202777 | LA |
N | 207N00000X | Dermatologist | ML20008479 | WA |
Y | 207ND0101X | MOHS-Micrographic Surgeon | 67421 | GA |
N | 207ND0101X | MOHS-Micrographic Surgeon | A115940 | CA |
NPI | 1164531166 |
---|---|
Provider Name | Dr. Jing Feng Gill |
First Address | Lawrenceville, GA 30046-4386 |
Second Address | Lawrenceville, GA 30046-4386 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 31/10/2012 |