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General NPI Number Information
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NPI Number | 1437795101
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Entity Type | Organization
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Legal Business Name | GEORGE NOVAK PLASTIC SURGERY PA
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Dates
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Enumeration Date | 11/18/2019
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Last Update Date | 11/18/2019
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Provider Practice Location Address
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Address Line | 994 AIRPORT RD
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City | DESTIN
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State | FL
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Zip | 32541-2820
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Country | US
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Telephone | 850-837-7777
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Fax | 850-837-8801
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Provider Business Mailing Address
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Address Line | 994 AIRPORT RD
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City | DESTIN
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State | FL
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Zip | 32541-2820
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Country | US
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Telephone | 850-837-7777
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Fax | 850-837-8801
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Authorized Official
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Title or Position | MEDICAL BILLER
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Name | TONIA BATISTE
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Credential | DO
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Telephone | 850-837-7777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number |
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License Number State |
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