Organization
PLASTIKOS PLASTIC AND RECONSTRUCTIVE SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUSAN KOLB M.D. (OWNER/PLASTIC SURGEON)
(770) 457-4677
Entity
Organization
Contact information
Practice address
4370 GEORGETOWN SQ, ATLANTA, GA 30338-6205
(770) 457-4677
(770) 457-4428
Mailing address
4370 GEORGETOWN SQ, ATLANTA, GA 30338-6205
(770) 457-4677
(770) 457-4428
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
31272
GA
2082S0105X
Surgery of the Hand (Plastic Surgery) Physician
31272
GA
213EP1101X
Primary Podiatric Medicine Podiatrist
POD001047
GA
213ES0103X
Foot & Ankle Surgery Podiatrist
POD001047
GA
Other
Enumeration date
07/18/2006
Last updated
12/28/2007
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