Organization
PLASTIC AND RECONSTRUCTIVE SURGERY CENTER, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GEORGE STEPHENSON DREW MD (OWNER CEO)
(706) 724-7288
Entity
Organization
Contact information
Practice address
820 SAINT SEBASTIAN WAY, SUITE 1A, AUGUSTA, GA 30901-2643
(706) 724-7288
(706) 724-7394
Mailing address
820 SAINT SEBASTIAN WAY, SUITE 1A, AUGUSTA, GA 30901-2643
(706) 724-7288
(706) 724-7394
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300028217A
—
GA
Enumeration date
06/12/2007
Last updated
04/16/2012
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