Southeastern Aesthetic Surgery, LLC

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

59595 Issued in GA

Legal business name

SOUTHEASTERN AESTHETIC SURGERY, LLC

Practice address

447 N Belair Rd
Suite 105
Evans, GA 30809-3090

Phone

(561) 310-1668

NPI assigned

May 1, 2011

Organization subpart

No

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

Authorized official

Name

Dr. William Troy Austin, M.D.

Title

Managing Member

Phone

(561) 310-1668

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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

• Marissa K Byrd, NP

  • Family Nurse Practitioner
  • Savannah, GA
  • NPI 1295405728
  NPD (past)
• Kelli Lane Evans, FNP-BC

  • Family Nurse Practitioner
  • Evans, GA
  • NPI 1871055210
  NPD (past)

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

{
    "created_epoch": "1304208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304208000000",
    "number": "1962793505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4115 COLUMBIA RD",
            "address_2": "SUITE 5331",
            "city": "MARTINEZ",
            "state": "GA",
            "postal_code": "309070405",
            "telephone_number": "561-310-1668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "447 N BELAIR RD",
            "address_2": "SUITE 105",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308093090",
            "telephone_number": "561-310-1668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEASTERN AESTHETIC SURGERY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-01",
        "last_updated": "2011-05-01",
        "status": "A",
        "authorized_official_last_name": "AUSTIN",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "TROY",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "561-310-1668",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": "GA",
            "license": "59595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• SNH Georgia Tenant LLC (Morningside of Evans)
• Solara Integrative Therapy LLC
• Victor Alejandro Soto Velazquez
• Kevin Scott Soto, PT
• Southeast Surgical Assistants, LLC
• Southeastern Medical Brokers, Inc. (Integrity Medical)
• Southern Anesthesia Service
• Southern Oaks Counseling, LLC
• Southern Pines Recovery, LLC
• Southern Weight Loss Clinic, LLC

• Plastic Surgery Physician in Evans, GA
• Providers in Evans, 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 May 1, 2011; 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.