Midtown Plastic Surgery, LLC

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

046220 Issued in GA

Legal business name

MIDTOWN PLASTIC SURGERY, LLC

Practice address

1418 Dresden Dr NE Ste 120
Atlanta, GA 30319-3599

Phone

(404) 754-1994

Fax

(770) 783-8975

NPI assigned

Nov 4, 2008

Last updated

Sep 3, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Puli Pravin Reddy, M.D.NPI 1487835260

Title

President

Phone

(404) 754-1994

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Puli Pravin Reddy, MD

  • Plastic and Reconstructive Surgery Physician
  • Atlanta, GA
  • NPI 1487835260

  Plastic Surgery

  NPD (past) Authorized official

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

{
    "created_epoch": "1225756800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409702400000",
    "number": "1790939783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925B PEACHTREE ST NE UNIT 375",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303093918",
            "telephone_number": "404-754-1994",
            "fax_number": "770-783-8975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1418 DRESDEN DR NE STE 120",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303193599",
            "telephone_number": "404-754-1994",
            "fax_number": "770-783-8975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDTOWN PLASTIC SURGERY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-04",
        "last_updated": "2014-09-03",
        "status": "A",
        "authorized_official_last_name": "REDDY",
        "authorized_official_first_name": "PULI",
        "authorized_official_middle_name": "PRAVIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "404-754-1994",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "GA",
            "license": "046220",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI INDIVIDUAL",
            "identifier": "1487835260",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Midtown Management Services, LLC
• Midtown Medical Associates, LLC
• Midtown Medical Center, LLC
• Midtown Neurology, P.C.
• Midtown Optical Inc
• Midtown Smile Center
• Midtown Specialty Group, LLC
• Midtown Surgical Associates, Inc
• Midtown Urology Anesthesia LLC
• Midtown Urology PC

• Plastic Surgery Physician in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Plastic Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2014; 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.