Southern Plastic Surgery, P.C.

Primary specialty

SpecialistTaxonomy code 174400000X

License

037728 Issued in GA

Legal business name

SOUTHERN PLASTIC SURGERY, P.C.

Practice address

3855 Pleasant Hill Rd
Suite 370
Duluth, GA 30096-1407

Phone

(770) 622-9100

Fax

(770) 622-9822

NPI assigned

Mar 28, 2012

Organization subpart

No

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

Authorized official

Name

Mrs. Jacqueline Madison

Title

Practice Manager

Phone

(770) 622-9100

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1332892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332892800000",
    "number": "1528334190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3855 PLEASANT HILL RD",
            "address_2": "SUITE 370",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300961407",
            "telephone_number": "770-622-9100",
            "fax_number": "770-622-9822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3855 PLEASANT HILL RD",
            "address_2": "SUITE 370",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300961407",
            "telephone_number": "770-622-9100",
            "fax_number": "770-622-9822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN PLASTIC SURGERY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-28",
        "last_updated": "2012-03-28",
        "status": "A",
        "authorized_official_last_name": "MADISON",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "770-622-9100",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "GA",
            "license": "037728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adama Sow, RN
• Sandra J Spahn, M.S.
• Lisa Ann Sparks, RPH
• Special Care Optometry of Georgia, LLC

• Specialist in Duluth, GA
• Providers in Duluth, GA by specialty
• Specialist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2012; 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.