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Organization
SOUTHEASTERN AESTHETIC AND RECONSTRUCTIVE SURGERY
Active
Organization
SOUTHEASTERN AESTHETIC AND RECONSTRUCTIVE SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FREDERICK LETOIS DURDEN JR. M.D. (PHYSICIAN)
(404) 642-7722
Entity
Organization
Contact information
Practice address
155 GREENVILLE ST, NEWNAN, GA 30263-2630
(404) 642-7722
Mailing address
155 GREENVILLE ST, NEWNAN, GA 30263-2630
(404) 642-7722
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
65539
GA
Other
Enumeration date
02/24/2017
Last updated
02/24/2017
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