MEDICARE: HAGOPIAN PLASTIC SURGERY, P.C.

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
1	208200000X	Plastic Surgery Physician

General Provider Information

NPI Number	:	1902517337
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HAGOPIAN PLASTIC SURGERY, P.C.

Provider Business Mailing Address
First Line	:	99 KROG ST NE UNIT C110
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30307-2677
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	99 KROG ST NE UNIT C110
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30307-2677
Country	:	US
Telephone Number	:	404-885-8542
Fax Number	:	404-885-8547

Authorized Official
Title or Position	:	CEO
Name	:	DR. THOMAS MARTIN HAGOPIAN
Credential	:	MD
Telephone Number	:	561-723-4647

Provider Enumeration Date	:	12/06/2022
Last Update Date	:	04/07/2023

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