Healthcare Provider Details

I. General information

NPI: 1801187802
Provider Name (Legal Business Name): AESTHETIC PLASTIC SURGERY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2011
Last Update Date: 04/25/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

506 RIVERSIDE PKWY NE STE 200
ROME GA
30161-2902
US

IV. Provider business mailing address

506 RIVERSIDE PKWY NE STE 200
ROME GA
30161-2902
US

V. Phone/Fax

Practice location:
  • Phone: 706-291-0200
  • Fax: 706-291-0248
Mailing address:
  • Phone: 706-291-0200
  • Fax: 706-291-0248

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. HARRY EUGENE DAWSON JR.
Title or Position: OWNER/PRESIDENT
Credential: M.D.
Phone: 706-291-0200