Provider Type Icon

PLASTIC SURGERY CENTER OF THE SOUTH NPI 1295885465


NPI Information

NPI: 1295885465
Provider Name: PLASTIC SURGERY CENTER OF THE SOUTH
Classification: Clinic/Center - 261Q00000X
Entity Type: Organization

CLIA Number: 11D2050208

Address:
120 VANN ST NE
SUITE 150
MARIETTA, GA
ZIP 30060
Phone: (772) 421-1242
Get Directions

PLASTIC SURGERY CENTER OF THE SOUTH is a clinic center in Marietta, GA. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). PLASTIC SURGERY CENTER OF THE SOUTH NPI is 1295885465. The provider is registered as an organization entity type.

The provider's business location address is:

120 VANN ST NE
SUITE 150
MARIETTA, GA
ZIP 30060-250
Phone: (772) 421-1242
Fax: (770) 424-6652

The provider's authorized official is James Edgar Leake .
The authorized official title is Medical Director and has the following contact phone number (770) 421-1242.

The CLIA number assigned to this NPI record is 11D2050208 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/11/2007 and was last updated on 8/22/2020.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261Q00000XClinic/Center261QA1903XGEORGIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.