PLASTIC SURGERY CENTER OF WEST GEORGIA NPI 1497897474

NPI Information

NPI: 1497897474
Provider Name: PLASTIC SURGERY CENTER OF WEST GEORGIA

Doing Business As: WEST GEORGIA CENTER FOR PLASTIC SURGERY

Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

Address:
150 HENRY BURSON AVE
SUITE 200
CARROLLTON, GA
ZIP 30117
Phone: (770) 834-6302
Get Directions

PLASTIC SURGERY CENTER OF WEST GEORGIA is an ambulatory surgical clinic center in Carrollton, GA. PLASTIC SURGERY CENTER OF WEST GEORGIA NPI is 1497897474. The provider is registered as an organization entity type.
The provider Is Doing Business As West Georgia Center For Plastic Surgery.

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 11D2299924 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/13/2007 and was last updated on 9/21/2010.

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
1	261QA1903X	Clinic/Center	Ambulatory Surgical	030330	GEORGIA	Yes

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
1	R566	OTHER	GEORGIA	AMERIHEALTH
2	0007430251	OTHER	GEORGIA	AETNA PPO
3	0007849777	OTHER	GEORGIA	AETNA
4	=========	OTHER	GEORGIA	ALL PLANS

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: 5/5/2024

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