Organization
EAR NOSE AND THROAT FACIAL PLASTICS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BOOKER TERRY SEYMOUR III MD (PRESIDENT)
(404) 350-9200
Entity
Organization
Contact information
Practice address
550 PEACHTREE ST NE, SUITE 1075, ATLANTA, GA 30308-2247
(404) 350-9200
(404) 529-9092
Mailing address
550 PEACHTREE ST NE, SUITE 1075, ATLANTA, GA 30308-2247
(404) 350-9200
(404) 529-9092
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
039935
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000663891A
—
GA
Enumeration date
11/20/2008
Last updated
04/07/2016
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