Organization
SOUTHEASTERN AESTHETIC SURGERY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM TROY AUSTIN M.D. (MANAGING MEMBER)
(561) 310-1668
Entity
Organization
Contact information
Practice address
447 N BELAIR RD, SUITE 105, EVANS, GA 30809-3090
(561) 310-1668
Mailing address
4115 COLUMBIA RD, SUITE 5331, MARTINEZ, GA 30907-0405
(561) 310-1668
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
59595
GA
Other
Enumeration date
05/01/2011
Last updated
05/01/2011
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