Ear, Nose & Throat Plastic Surgery Center

Primary specialty

Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X

Legal business name

EAR, NOSE & THROAT PLASTIC SURGERY CENTER

Practice address

6130 Prestley Mill Rd Ste C
Douglasville, GA 30134-2288

Phone

(678) 838-3903

Fax

(678) 838-7454

NPI assigned

Nov 21, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Neil Anthony Persaud, D.ONPI 1356428700

Title

Owner

Phone

(678) 838-3903

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Neil A Persaud, D.O

  • Otolaryngology/Facial Plastic Surgery Physician
  • Douglasville, GA
  • NPI 1356428700

  GA

  Medicare reassignment Care Compare group Authorized official
• Andrew Paul Barak, DO

  • Otolaryngology Physician
  • Douglasville, GA
  • NPI 1508824152

  GA

  Medicare reassignment Care Compare group NPD
• Jahmal A Hairston, M.D.

  • Otolaryngology Physician
  • Douglasville, GA
  • NPI 1922187871

  GA

  Medicare reassignment Care Compare group NPD
• Cang Trung Nguyen, DO

  • Otolaryngology/Facial Plastic Surgery Physician
  • Douglasville, GA
  • NPI 1154860518

  GA, Otolaryngology/Facial Plastic Surgery

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1821163577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6130 PRESTLEY MILL RD STE C",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301342288",
            "telephone_number": "678-838-3903",
            "fax_number": "678-838-7454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6130 PRESTLEY MILL RD STE C",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301342288",
            "telephone_number": "678-838-3903",
            "fax_number": "678-838-7454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAR, NOSE & THROAT PLASTIC SURGERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PERSAUD",
        "authorized_official_first_name": "NEIL",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-838-3903",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O"
    },
    "taxonomies": [
        {
            "code": "207YX0905X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CH6392",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Samuel Grey Barnhouse Durrett, M.D.
• Dva Healthcare Renal Care Inc
• Hilda Dwumfuor
• Shevander Dykes, MA, LPC
• Charles Eaddy II
• Kevin Alexander Eason
• Sarah Eason, FNP-C
• Janine Eastman, PHLEBOTOMIST
• Madeline Rose Easton, MD
• Easy Touch Personal Home Care LLC

• All providers in Douglasville, GA
• Otolaryngology/Facial Plastic Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.