Provider Demographics
NPI:1427499615
Name:LEE, JAEYOUNG (MD)
Entity type:Individual
Prefix:
First Name:JAEYOUNG
Middle Name:
Last Name:LEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1325 SATELLITE BLVD NW
Mailing Address - Street 2:STE 701
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-4676
Mailing Address - Country:US
Mailing Address - Phone:678-417-1255
Mailing Address - Fax:678-417-1258
Practice Address - Street 1:1325 SATELLITE BLVD NW STE 701
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-4676
Practice Address - Country:US
Practice Address - Phone:678-417-1255
Practice Address - Fax:678-417-1258
Is Sole Proprietor?:No
Enumeration Date:2013-07-16
Last Update Date:2025-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA265870207R00000X
GA84696207R00000X
RILP02885207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine