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Organization

SOUTHERN PLASTIC SURGERY, P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. JACQUELINE MADISON (PRACTICE MANAGER)
(770) 622-9100
Entity
Organization

Contact information

Practice address
3855 PLEASANT HILL RD, SUITE 370, DULUTH, GA 30096-1407
(770) 622-9100
(770) 622-9822
Mailing address
3855 PLEASANT HILL RD, SUITE 370, DULUTH, GA 30096-1407
(770) 622-9100
(770) 622-9822

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
037728
GA

Other

Enumeration date
03/28/2012
Last updated
03/28/2012
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