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Organization

RECONSTRUCTIVE AND PLASTIC UROLOGY LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KENNETH JEFF CARNEY MD (OWNER)
(404) 593-1176
Entity
Organization

Contact information

Practice address
3193 HOWELL MILL RD NW STE 322, ATLANTA, GA 30327-2100
(470) 788-8379
Mailing address
955 CLIFTON RD NE, ATLANTA, GA 30307-1225
(404) 593-1176

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary

Other

Enumeration date
05/16/2022
Last updated
05/16/2022
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