Organization
ATLANTA AESTHETIC AND RECONSTRUCTIVE SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. FREDERICK T WORK II M.D. (MEDICAL DIRECTOR)
(404) 885-9675
Entity
Organization
Contact information
Practice address
1 BALTIMORE PL NW STE 400, ATLANTA, GA 30308-2117
(404) 885-9675
(404) 875-4017
Mailing address
595 PIEDMONT AVE NE STE 320-359, ATLANTA, GA 30308-2478
(404) 885-9675
(404) 875-4017
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
060-437
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000685352F
—
GA
Enumeration date
02/08/2011
Last updated
03/29/2011
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