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Contact Information

SOUTHEASTERN AESTHETIC AND RECONSTRUCTIVE SURGERY
155 GREENVILLE ST
NEWNAN, GA30263-2630
 Phone: 404-642-7722
 Fax:
 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 AESTHETIC AND RECONSTRUCTIVE SURGERY

NPI # 1093255044
LBN Legal business name SOUTHEASTERN AESTHETIC AND RECONSTRUCTIVE SURGERY
Authorized official FREDERICK DURDEN - (PHYSICIAN)
Entity Organization
Organization subpart 1 No
Enumeration date 02/24/2017
Last updated 02/24/2017 - About 9 years ago
Identifiers
GA License # 65539
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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