MARIETTA PLASTIC SURGERY (NPI# 1164746244) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164746244 |
| Entity Type | Organization |
| Organization Name | MARIETTA PLASTIC SURGERY |
| Practice Address |
149 Towne Lake Pkwy Woodstock GA 30188-4859 |
| Practice Telephone | 6784942380 |
| Practice Fax Number | 6784942379 |
| Mailing Telephone | 6784942380 |
| Mailing Fax Number | 6784942379 |
| Enumeration Date | 2010-03-18 |
| Last Update Date | 2010-03-18 |
| Authorized Official Name | DONNA MARIE BOCKHORST (PRACTICE ADMIN) |
| Authorized Official Telephone | 7704250118 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
GA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417116567 | Marietta Plastic Surgery | Clinic/Center | 823 Campbell Hill St Nw, Marietta, GA 30060-1144 | 2008-06-04 |
| 1316165723 | Marietta Plastic Surgery | Surgery | 823 Campbell Hill St Nw, Marietta, GA 30060-1144 | 2007-04-23 |
| Street Address |
149 TOWNE LAKE PKWY |
| City | WOODSTOCK |
| State | GA |
| Zip Code | 30188-4859 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932167467 | Anar Desai Maurya | Optometrist | 149 Towne Lake Pkwy, Ste 102, Woodstock, GA 30188-4859 | 2006-05-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730715814 | Tyler Rose | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 116 South Mill Creek Court, Woodstock, GA 30188 | 2020-03-20 |
| 1881224897 | Dr. Tom LLC | Clinic/Center | 5431 Old Highway 5 Ste 206, Holly Springs, GA 30188 | 2020-01-17 |
| 1467090175 | Stacey Robin Hill | Dietitian, Registered | 210 Mcaffee St, Street Address 2, Woodstock, GA 30188 | 2019-12-12 |
| 1326681784 | Margo Vanderveen | Massage Therapist | 605 Old Hickory Road, Woodstock, GA 30188 | 2019-10-17 |
| 1275093437 | Rebekah Ruth Tchouta | Social Worker | 5166 Shotwell St, Woodstock, GA 30188 | 2019-03-23 |
| 1205395829 | Angela M Graves | Behavior Technician | 3229 S Cherokee Ln Ste 1400, Woodstock, GA 30188 | 2019-03-13 |
| 1396233391 | Costco Wholesale Corporation | Hearing Aid Equipment | 113 Lincoln Street, Woodstock, GA 30188 | 2018-04-25 |
| 1659878080 | Alexis K. Brown | Counselor | 3380 Trickum Rd., Bldg 700, Woodstock, GA 30188 | 2018-04-11 |
| 1427555440 | Lisa Marie Anthony | Specialist/Technologist | 400 Arnold Mill Rd, Woodstock, GA 30188 | 2018-04-06 |
| 1497254122 | J.a.h. Enterprises, LLC | Audiologist | 12195 Hwy. 92, Suite 114-325, Woodstock, GA 30188 | 2018-02-08 |
| Find all providers in zip 30188 | ||||
| Taxonomy Code | 2086S0122X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Plastic and Reconstructive Surgery |
| A surgeon who specializes in plastic and reconstructive surgery. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427668342 | Spa Medical LLC | Surgery | 455 Plum St, Macon, GA 31201-3368 | 2020-08-05 |
| 1356972848 | North Atlanta Plastic Surgery Group LLC | Surgery | 11877 Douglas Rd Ste 102-367, Johns Creek, GA 30005-4325 | 2020-02-03 |
| 1881100337 | Rpc Employee Services, LLC | Surgery | 975 Johnson Ferry Rd Ste 100, Atlanta, GA 30342-1618 | 2017-12-20 |
| 1093255044 | Southeastern Aesthetic and Reconstructive Surgery | Surgery | 155 Greenville St, Newnan, GA 30263-2630 | 2017-02-24 |
| 1700249042 | Justin Kyle Williams | Surgery | 3200 Downwood Cir Nw Ste 640-4, Atlanta, GA 30327-1610 | 2016-04-04 |
| 1871901009 | Southeastern Reconstructive Services LLC | Surgery | 5205 Frederick St Ste B, Savannah, GA 31405-4520 | 2014-07-31 |
| 1730479452 | Olumayowa Pitan Abiodun | Surgery | 2709 Meredyth Dr Ste 340, Albany, GA 31707 | 2011-04-14 |
| 1609175421 | Randal H. Rudderman Md Inc | Surgery | 3400-c Old Milton Pkwy, Ste 450, Alpharetta, GA 30005-3707 | 2011-03-18 |
| 1033374392 | James Bradford Depew | Surgery | 120 Vann St Ne Ste 150, Marietta, GA 30060 | 2008-07-25 |
| 1255591814 | Corey Patrick Harkins | Surgery | 120 Vann Street, Suite 150, Marietta, GA 30060 | 2008-06-16 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.