PLASTIKOS PLASTIC AND RECONSTRUCTIVE SURGERY NPI 1124046990

NPI Information

  • NPI: 1124046990
  • Provider Name: PLASTIKOS PLASTIC AND RECONSTRUCTIVE SURGERY
  • Classification: Plastic Surgery - 208200000X
  • Entity Type: Organization
  • Address: 4370 GEORGETOWN SQ
    ATLANTA, GA
    ZIP 30338
  • Phone: (770) 457-4677

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NPI Details

PLASTIKOS PLASTIC AND RECONSTRUCTIVE SURGERY is a plastic surgery in Atlanta, GA. The provider is a plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well. PLASTIKOS PLASTIC AND RECONSTRUCTIVE SURGERY NPI is 1124046990. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

4370 GEORGETOWN SQ
ATLANTA, GA
ZIP 30338-205
Phone: (770) 457-4677
Fax: (770) 457-4428

The provider's authorized official is Susan Kolb .
The authorized official title is Owner/plastic Surgeon and has the following contact phone number (770) 457-4677.

The enumeration date for this NPI number is 7/18/2006 and was last updated on 12/28/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12082S0105XPlastic SurgerySurgery of the Hand31272GEORGIANo
2213ES0103XPodiatristFoot & Ankle SurgeryPOD001047GEORGIANo
3213EP1101XPodiatristPrimary Podiatric MedicinePOD001047GEORGIANo
4208200000XPlastic Surgery31272GEORGIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1GRP2514MEDICARE PINGEORGIA

What is NPI?

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This page was last updated on: 11/21/2025

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