National Provider Identifier Database

AVENUE AESTHETIC AND RECONSTRUCTIVE SURGERY LLC
Medical Specialty

An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).


Contact Information

AVENUE AESTHETIC AND RECONSTRUCTIVE SURGERY LLC
489 N MILLEDGE AVE
ATHENS, GA30601-3807
Phone: 706-363-0256
Fax: 706-622-4360
Website:
Specialty Taxonomy Code
* Medical Specialty 261QM2500X

* Indicates primary specialty

NPI Profile & details for AVENUE AESTHETIC AND RECONSTRUCTIVE SURGERY LLC

NPI Number 1336912021
Legal business name
LBN
AVENUE AESTHETIC AND RECONSTRUCTIVE SURGERY LLC
Authorized official JESSICA BAVANI - (OFFICE MANAGER)
Entity Organization
Organization subpart No
Enumeration date 11/03/2023
Last updated 11/03/2023 - About 3 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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