Advanced Aesthetics PC
Organization Active NPI Ambulatory Surgical Clinic/Center · Fayetteville, GA
NPI 1962441709 · NPPES record last updated Aug 23, 2012
Key facts
- NPI
- 1962441709
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Ambulatory Surgical Clinic/Center 261QA1903X
- Legal business name
- ADVANCED AESTHETICS PC
- Practice address
- 874 W Lanier Ave
Ste 110
Fayetteville, GA 30214-7659 - Phone
- (770) 461-4000
- Fax
- (770) 461-2790
- NPI assigned
- Jun 6, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- ADVANCED AESTHETICS, PC
Authorized official
- Name
- Mrs. Diane Rodriguez
- Title
- Office Manager
- Phone
- (770) 461-4000
Practitioners 6
-
Paul David Feldman, M.D.
-
Amanda Lynn Fowler, PA-C
-
Edward Scott Gronka, M.D.
-
Joseph Raniere,Jr, M.D.
-
Joel M Stewart Jr., M.D.
-
Takintope Akinbiyi, M.D.
National Provider Directory
- Part of
- Advanced Aesthetics PC
Locations
170 Bastille Way
Ste B
Fayetteville, GA 30214
Phone (770) 461-4000
874 Lanier Ave W
Ste 100
Fayetteville, GA 30214
Phone (770) 461-4000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Surgical Clinic/Center | 261QA1903X | Yes |
Addresses
Primary practice location
874 W Lanier Ave
Ste 110
Fayetteville, GA 30214-7659
Mailing address
874 W Lanier Ave
Ste 100
Fayetteville, GA 30214-7659
Phone (770) 461-4000
Other names
- Advanced Aesthetics PC
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 23, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.