Organization
PLASTIC SURGERY CENTER OF THE SOUTH
Active
Organization
PLASTIC SURGERY CENTER OF THE SOUTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES EDGAR LEAKE M.D. (MEDICAL DIRECTOR)
(770) 421-1242
Entity
Organization
Contact information
Practice address
120 VANN ST NE, SUITE 150, MARIETTA, GA 30060-7250
(772) 421-1242
(770) 424-6652
Mailing address
120 VANN ST NE, SUITE 150, MARIETTA, GA 30060-7250
(772) 421-1242
(770) 424-6652
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
261QA1903X
GA
Other
Enumeration date
01/11/2007
Last updated
08/22/2020
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