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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