Southeastern Aesthetic and Reconstructive Surgery

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

License

65539 Issued in GA

Legal business name

SOUTHEASTERN AESTHETIC AND RECONSTRUCTIVE SURGERY

Practice address

155 Greenville St
Newnan, GA 30263-2630

Phone

(404) 642-7722

NPI assigned

Feb 24, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Frederick Letois Durden Jr., M.D.

Title

Physician

Phone

(404) 642-7722

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1487894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487894400000",
    "number": "1093255044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 GREENVILLE ST",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302632630",
            "telephone_number": "404-642-7722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 GREENVILLE ST",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302632630",
            "telephone_number": "404-642-7722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEASTERN AESTHETIC AND RECONSTRUCTIVE SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-24",
        "last_updated": "2017-02-24",
        "status": "A",
        "authorized_official_last_name": "DURDEN",
        "authorized_official_first_name": "FREDERICK",
        "authorized_official_middle_name": "LETOIS",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "404-642-7722",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "GA",
            "license": "65539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victoria Marie Sommer
• Sheila Sonnenberg, NP
• Elizabeth Soto
• South Atlanta Heart and Vascular Clinic LLC
• Southeast Perinatal Counseling LLC
• Southeastern Behavioral Health and Consulting
• Southeastern Regional Medical Center, Inc.
• Southeastern Regional Medical Center, Inc.
• Southern Bone & Joint Ambulatory Surgical Center, LLC
• Southern Home Care Services, Inc.

• Plastic and Reconstructive Surgery Physician in Newnan, GA
• Providers in Newnan, GA by specialty
• Plastic and Reconstructive Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.