Organization
PLASTIKOS SURGERY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. FELICIA A WILSON (MANAGER CBO)
(678) 514-2108
Entity
Organization
Contact information
Practice address
4370 GEORGETOWN SQUARE, ATLANTA, GA 30338-6205
(770) 457-4677
(678) 514-2104
Mailing address
4370 GEORGETOWN SQUARE, ATLANTA, GA 30338
(678) 514-2108
(678) 514-2104
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
—
—
2082S0105X
Surgery of the Hand (Plastic Surgery) Physician
—
—
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Enumeration date
06/19/2007
Last updated
09/14/2016
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