National Provider Identifier Database

SPA MEDICAL LLC
Plastic and Reconstructive Surgery


Contact Information

SPA MEDICAL LLC
455 PLUM ST
MACON, GA31201-3368
Phone: 478-743-2209
Fax:
Website:
Specialty Taxonomy Code
* Plastic and Reconstructive Surgery 2086S0122X

* Indicates primary specialty

NPI Profile & details for SPA MEDICAL LLC

NPI Number 1427668342
Legal business name
LBN
SPA MEDICAL LLC
Authorized official KENNETH HARPER - (OWNER)
Entity Organization
Organization subpart No
Enumeration date 08/05/2020
Last updated 10/06/2020 - About 6 years ago
Sole proprietor1 Not specified
Identifiers n/a

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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