Healthcare Provider Details

I. General information

NPI: 1295734259
Provider Name (Legal Business Name): THE GEORGIA INSTITUTE FOR PLASTIC SURGERY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2005
Last Update Date: 11/13/2023
Certification Date: 11/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5361 REYNOLDS ST
SAVANNAH GA
31405-6014
US

IV. Provider business mailing address

5361 REYNOLDS ST
SAVANNAH GA
31405-6014
US

V. Phone/Fax

Practice location:
  • Phone: 912-355-8000
  • Fax: 912-355-8403
Mailing address:
  • Phone: 912-355-8000
  • Fax: 912-355-8403

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: RICHARD J GRECO
Title or Position: CEO
Credential: M.D.
Phone: 912-355-8000