Organization · Type 2 NPI
Celestial Plastic and Reconstructive Surgery
Plastic and Reconstructive Surgery Physician · College Park, GA
NPI number
1619479201
Active
Practice location
2230 Godby Rd
College Park, GA 30349-5002
Fax (404) 393-1695
Mailing address
3645 Marketplace Blvd Ste 130-559
East Point, GA 30344-5747
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Plastic Surgery Physician | 208200000X | 70539 (GA) |
| Plastic Surgery Physician | 208200000X | None listed |
| Plastic and Reconstructive Surgery Physician Primary | 2086S0122X | None listed |
Plastic and Reconstructive Surgery Physician: A surgeon who specializes in plastic and reconstructive surgery.
2 other providers at this address
About NPI 1619479201
Celestial Plastic and Reconstructive Surgery's National Provider Identifier is 1619479201, issued on Feb 28, 2018. The primary taxonomy on file is Plastic and Reconstructive Surgery Physician (2086S0122X), and the practice location is in College Park, GA. The record was last updated on Jun 1, 2022.