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Organization
CENTER FOR PLASTIC & RECONSTRUCTIVE SURGERY PSC
Active
Organization
CENTER FOR PLASTIC & RECONSTRUCTIVE SURGERY PSC
Active
Other names
Atalla Plastic Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FOUAD V ATALLA M.D. (PRESIDENT/OWNER)
(270) 796-8960
Entity
Organization
Contact information
Practice address
1048 ASHLEY ST STE 303, BOWLING GREEN, KY 42103-2451
(270) 796-8960
(270) 842-5683
Mailing address
1048 ASHLEY ST STE 303, BOWLING GREEN, KY 42103-2451
(270) 796-8960
(270) 842-5683
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
33744
KY
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
65903460
—
KY
Enumeration date
09/20/2006
Last updated
10/07/2020
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