PEDIATRIC PLASTIC SURGERY AND CRANIOFACIAL ASSOCIATES PC NPI 1639206030

NPI Information

  • NPI: 1639206030
  • Provider Name: PEDIATRIC PLASTIC SURGERY AND CRANIOFACIAL ASSOCIATES, PC
  • Classification: Surgery - 2086S0122X
  • Specialization: Plastic and Reconstructive Surgery
  • Entity Type: Organization
  • Address: 975 JOHNSON FERRY RD NE
    SUITE 500
    ATLANTA, GA
    ZIP 30342
  • Phone: (404) 256-1311

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NPI Details

PEDIATRIC PLASTIC SURGERY AND CRANIOFACIAL ASSOCIATES, PC is a plastic and reconstructive surgery surgery in Atlanta, GA. The provider is a surgeon who specializes in plastic and reconstructive surgery. PEDIATRIC PLASTIC SURGERY AND CRANIOFACIAL ASSOCIATES, PC NPI is 1639206030. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

975 JOHNSON FERRY RD NE
SUITE 500
ATLANTA, GA
ZIP 30342-619
Phone: (404) 256-1311
Fax: (404) 705-2772

The provider's authorized official is Andy Guth .
The authorized official title is Executive Director and has the following contact phone number (404) 256-1311.

The enumeration date for this NPI number is 2/27/2007 and was last updated on 7/21/2022.

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
12086S0122XSurgeryPlastic and Reconstructive SurgeryGEORGIAYes

What is NPI?

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This page was last updated on: 3/30/2025

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