Provider First Line Business Practice Location Address: 
1325 SATELLITE BLVD NW BLDG 700
    Provider Second Line Business Practice Location Address: 
JK INTERNAL MEDICINE & GERIATRICS. P.C.
    Provider Business Practice Location Address City Name: 
SUWANEE
    Provider Business Practice Location Address State Name: 
GA
    Provider Business Practice Location Address Postal Code: 
30024-4651
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
678-417-1255
    Provider Business Practice Location Address Fax Number: 
678-417-1258
    Provider Enumeration Date: 
12/22/2011