Organization
STATESBORO PLASTIC SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK E BISSECK M.D. (PHYSICIAN/OWNER)
(912) 681-3330
Entity
Organization
Contact information
Practice address
1402 BRAMPTON AVE, STATESBORO, GA 30458
(912) 681-3330
(912) 681-3303
Mailing address
1402 BRAMPTON AVE, STATESBORO, GA 30458
(912) 681-3330
(912) 681-3303
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
061556
GA
Other
Enumeration date
09/19/2008
Last updated
10/16/2012
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