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Contact Information

SOUTHEASTERN RECONSTRUCTIVE SERVICES LLC
5205 FREDERICK ST STE B
SAVANNAH, GA31405-4520
 Phone: 912-354-4969
 Fax: 912-354-5019
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Plastic and Reconstructive Surgery

2086S0122X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for SOUTHEASTERN RECONSTRUCTIVE SERVICES LLC · (Female)

NPI Number 1871901009
Status Active
Credentials
Entity Individual
Enumeration date 07/31/2014
Last updated 07/31/2014 - About 12 years ago
Sole proprietor 1 Not specified
Identifiers
  • LA License # 22651
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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