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NPI Code Detail

MEDICARE: ATLANTA PLASTIC & RECONSTRUCTIVE SURGERY CENTER, PC

MEDICARE: ATLANTA PLASTIC & RECONSTRUCTIVE SURGERY CENTER, PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QA1903XAmbulatory Surgical Clinic/Center040593GA

General Provider Information

NPI Number : 1225051584
Entity Type Code : Organization
Provider Name (Legal Business Name) : ATLANTA PLASTIC & RECONSTRUCTIVE SURGERY CENTER, PC
Provider Business Mailing Address
First Line : 1 BALTIMORE PL NW
Second Line : SUITE 400
City : ATLANTA
State : GA
Zip : 30308-2116
Country : US
Telephone Number : 404-885-9675
Fax Number : 404-759-2212
Provider Business Practice Location Address
First Line : 1 BALTIMORE PL NW
Second Line : SUITE 400
City : ATLANTA
State : GA
Zip : 30308-2116
Country : US
Telephone Number : 404-885-9675
Fax Number : 404-759-2212
Authorized Official
Title or Position : CEO
Name : FREDERICK T WORK JR.
Credential : M.D.
Telephone Number : 404-885-9675
Provider Enumeration Date : 07/26/2006
Last Update Date : 08/22/2020

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Directions to “ATLANTA PLASTIC & RECONSTRUCTIVE SURGERY CENTER, PC ” Practice Location

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