NPI:
1952391591
Provider Name:
WEST GEORGIA CENTER FOR PLASTIC SURGERY, LLC
Doing Business As: PLASTIC SURGERY CENTER OF WEST GEORGIA, LLC
Classification:
Clinic/Center - 261QA1903X
Entity Type:
Organization
Specialization: Ambulatory Surgical
CLIA Number: 11D2278592
Address:
150 HENRY BURSON AVE
SUITE 200
CARROLLTON, GA
ZIP 30117
Phone:
(770) 834-6302
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WEST GEORGIA CENTER FOR PLASTIC SURGERY, LLC is an ambulatory surgical clinic center in Carrollton, GA. WEST GEORGIA CENTER FOR PLASTIC SURGERY, LLC NPI is 1952391591. The provider is registered as an organization entity type.
The provider Is Doing Business As Plastic Surgery Center Of West Georgia, Llc.
The provider's business location address is:
150 HENRY BURSON AVE
SUITE 200
CARROLLTON, GA
ZIP 30117-465
Phone: (770) 834-6302
Fax: (770) 834-7660
The provider's authorized official is Stephen Housman Kahler .
The authorized official title is Principal Officer and has the following contact phone number (770) 834-6302.
The CLIA number assigned to this NPI record is 11D2278592 - ambulatory surgery center with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 10/25/2005 and was last updated on 9/21/2010.