Organization Active NPI

Southeastern Reconstructive Services LLC

  • Plastic and Reconstructive Surgery Physician
  • Savannah, GA
National Provider Identifier
1871901009
Registry record updated Jul 31, 2014
On this page

Key facts

NPPES NPI Registry
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
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Lori Wechsler
Title
Billing
Phone
(912) 354-4969

National Provider Directory

National Provider Directory

Locations

5205 Frederick St
Ste B
Savannah, GA 31405
Phone (912) 351-0591

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2086S0122X 22651 LA Primary

Addresses

NPPES NPI Registry

Primary practice location

5205 Frederick St Ste B
Savannah, GA 31405-4520

Mailing address

PO Box 15878
Savannah, GA 31416-2578
Phone (912) 354-4969

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 31, 2014.

{
    "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": []
}

Other providers in Savannah, GA

Sources for this page

  • 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.