WEST SIDE PLASTIC SURGERY, INC; NPI #1730380775

Contact Information

WEST SIDE PLASTIC SURGERY, INC

960 JOHNSON FERRY RD N.E.
SUITE 336
ATLANTA, GA 30342

Phone: 404-805-5535
Fax: 866-935-5995
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Plastic and Reconstructive Surgery	2086S0122X	02	Physician/General Surgery

Indicates primary specialty

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NPI Profile & details for WEST SIDE PLASTIC SURGERY, INC

NPI Number 1730380775

LBN Legal business name WEST SIDE PLASTIC SURGERY, INC

Authorized official VETRA GIPSON - (OWNER)

Entity Organization

Organization subpart ¹ No

Enumeration date 05/29/2007

Last updated 04/11/2011 - About 15 years ago

Identifiers

GA	License #	50518
GA	Medicaid	000963102B

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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WEST SIDE PLASTIC SURGERY, INC

Contact Information

Specialty

Plastic and Reconstructive Surgery

NPI Profile & details for WEST SIDE PLASTIC SURGERY, INC

Reviews for WEST SIDE PLASTIC SURGERY, INC