Southeastern Reconstructive Services LLC

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

License

22651 Issued in LA

Legal business name

SOUTHEASTERN RECONSTRUCTIVE SERVICES LLC

Practice address

5205 Frederick St Ste B
Savannah, GA 31405-4520

Phone

(912) 354-4969

Fax

(912) 354-5019

NPI assigned

Jul 31, 2014

Last updated

Jul 31, 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

Lori Wechsler

Title

Billing

Phone

(912) 354-4969

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1406764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406764800000",
    "number": "1871901009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15878",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314162578",
            "telephone_number": "912-354-4969",
            "fax_number": "912-354-5019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5205 FREDERICK ST STE B",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314054520",
            "telephone_number": "912-354-4969",
            "fax_number": "912-354-5019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEASTERN RECONSTRUCTIVE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-31",
        "last_updated": "2014-07-31",
        "status": "A",
        "authorized_official_last_name": "WECHSLER",
        "authorized_official_first_name": "LORI",
        "authorized_official_title_or_position": "BILLING",
        "authorized_official_telephone_number": "912-354-4969"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "LA",
            "license": "22651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Plastic and Reconstructive Surgery Physician in Savannah, GA
• Providers in Savannah, 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 Jul 31, 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.