National Provider Identifier Database

SOUTHERN CRESCENT PLASTIC SURGERY PC
Plastic and Reconstructive Surgery


Contact Information

SOUTHERN CRESCENT PLASTIC SURGERY, PC
919 EAGLES LANDING PKWY
STOCKBRIDGE, GA30281-5011
Phone: 770-389-0446
Fax: 770-389-3530
Website:
Specialty Taxonomy Code
* Plastic and Reconstructive Surgery 2086S0122X

* Indicates primary specialty

NPI Profile & details for SOUTHERN CRESCENT PLASTIC SURGERY, PC

NPI Number 1841573458
Legal business name
LBN
SOUTHERN CRESCENT PLASTIC SURGERY, PC
Authorized official ALICE GROSS - (ADMINISTRATOR)
Entity Organization
Organization subpart No
Enumeration date 09/21/2011
Last updated 09/21/2011 - About 15 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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