National Provider Identifier Database

WEST SIDE PLASTIC SURGERY INC
Plastic and Reconstructive Surgery


Contact Information

WEST SIDE PLASTIC SURGERY, INC
960 JOHNSON FERRY RD N.E.
SUITE 336
ATLANTA, GA30342
Phone: 404-805-5535
Fax: 866-935-5995
Website:
Specialty Taxonomy Code
* Plastic and Reconstructive Surgery 2086S0122X

* Indicates primary specialty

NPI Profile & details for WEST SIDE PLASTIC SURGERY, INC

NPI Number 1730380775
Legal business name
LBN
WEST SIDE PLASTIC SURGERY, INC
Authorized official VETRA GIPSON - (OWNER)
Entity Organization
Organization subpart No
Enumeration date 05/29/2007
Last updated 04/11/2011 - About 15 years ago
Sole proprietor1 Not specified
Identifiers
  • GA License #: 50518
  • GA Medicaid: 000963102B

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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