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Organization

NORTHEAST GEORGIA PLASTIC SURGERY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BRUCE M PARKER (PRACTICE MANAGER)
(770) 534-1856
Entity
Organization

Contact information

Practice address
1296 SIMS ST, SUITE B, GAINESVILLE, GA 30501-3850
(770) 534-1856
Mailing address
1296 SIMS ST, SUITE B, GAINESVILLE, GA 30501-3850
(770) 534-1856

Taxonomy

Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary

Other

Enumeration date
12/03/2007
Last updated
09/10/2024
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