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Organization

SIGNATURE PLASTIC SURGERY, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. EARL STEPHENSON MD (PHYSICIAN/OWNER)
(404) 642-4367
Entity
Organization

Contact information

Practice address
3543 HIGHWAY 81, LOGANVILLE, GA 30052-4336
(404) 642-4367
Mailing address
PO BOX 446, STONE MOUNTAIN, GA 30086-0446
(404) 642-4367

Taxonomy

Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
045975
GA

Other

Enumeration date
04/06/2009
Last updated
04/06/2009
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