Organization
AESTHETICA SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LOUIS POTYONDY M.D. (MEDICAL DOCTOR/MANAGER)
(229) 228-9900
Entity
Organization
Contact information
Practice address
505 GORDON AVE, THOMASVILLE, GA 31792-6645
(229) 228-9900
(229) 228-9477
Mailing address
505 GORDON AVE, THOMASVILLE, GA 31792-6645
(229) 228-9900
(229) 228-9477
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
057743
GA
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
02/08/2011
Last updated
02/08/2011
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