NPIMap

Organization Active NPI

Plastikos Plastic and Reconstructive Surgery

  • Plastic Surgery Physician
  • Atlanta, GA
National Provider Identifier
1124046990
Registry record updated Dec 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
31272 Issued in GA
Legal business name
PLASTIKOS PLASTIC AND RECONSTRUCTIVE SURGERY
Practice address
4370 Georgetown SQ
Atlanta, GA 30338-6205
Phone
(770) 457-4677
Fax
(770) 457-4428
NPI assigned
Jul 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2007

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

Authorized official

Name
Dr. Susan Kolb, M.D.
Title
Owner/Plastic Surgeon
Phone
(770) 457-4677

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208200000X 31272 GA Primary
Surgery of the Hand (Plastic Surgery) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2082S0105X 31272 GA
Primary Podiatric Medicine PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213EP1101X POD001047 GA
Foot & Ankle Surgery PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213ES0103X POD001047 GA

Addresses

Primary practice location

4370 Georgetown SQ
Atlanta, GA 30338-6205

Mailing address

4370 Georgetown SQ
Atlanta, GA 30338-6205
Phone (770) 457-4677

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198800000000",
    "number": "1124046990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4370 GEORGETOWN SQ",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303386205",
            "telephone_number": "770-457-4677",
            "fax_number": "770-457-4428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4370 GEORGETOWN SQ",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303386205",
            "telephone_number": "770-457-4677",
            "fax_number": "770-457-4428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLASTIKOS PLASTIC AND RECONSTRUCTIVE SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-18",
        "last_updated": "2007-12-28",
        "status": "A",
        "authorized_official_last_name": "KOLB",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "OWNER/PLASTIC SURGEON",
        "authorized_official_telephone_number": "770-457-4677",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Plastic Surgery",
            "state": "GA",
            "license": "31272",
            "primary": true
        },
        {
            "code": "2082S0105X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Plastic Surgery, Surgery of the Hand",
            "state": "GA",
            "license": "31272",
            "primary": false
        },
        {
            "code": "213EP1101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "GA",
            "license": "POD001047",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "GA",
            "license": "POD001047",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2007; 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.