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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