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General NPI Number Information
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NPI Number | 1992063606
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Entity Type | Organization
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Legal Business Name | ASTRA PLASTIC SURGERY, LLC
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Dates
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Enumeration Date | 05/01/2012
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Last Update Date | 04/07/2025
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Provider Practice Location Address
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Address Line | 3330 PRESTON RIDGE RD STE 380
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City | ALPHARETTA
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State | GA
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Zip | 30005-4596
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Country | US
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Telephone | 678-208-6008
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Fax |
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Provider Business Mailing Address
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Address Line | 3330 PRESTON RIDGE RD STE 380
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City | ALPHARETTA
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State | GA
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Zip | 30005-4596
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Country | US
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Telephone | 678-208-6008
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | CHRISTOPHER DAVID KILLINGSWORTH
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Credential | MD
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Telephone | 678-208-6008
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0105X
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Taxonomy Name | Surgery of the Hand (Surgery) Physician
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License Number | 67666
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number | 67666
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License Number State | GA
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