Organization
WEST GEORGIA CENTER FOR PLASTIC SURGERY, LLC
Active
Other names
Plastic Surgery Center of West Georgia, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN HOUSMAN KAHLER M.D. (PRINCIPAL OFFICER)
(770) 834-6302
Entity
Organization
Contact information
Practice address
150 HENRY BURSON AVE, SUITE 200, CARROLLTON, GA 30117-4465
(770) 834-6302
(770) 834-7660
Mailing address
150 HENRY BURSON AVE, SUITE 200, CARROLLTON, GA 30117-4465
(770) 834-6302
(770) 834-7660
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
030330
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0007430251
AETNA
GA
01
—
R566
COMMERCIAL INS./AMERIHEAL
GA
Enumeration date
10/25/2005
Last updated
09/21/2010
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