SOUTHEASTERN RECONSTRUCTIVE SERVICES LLC (NPI# 1871901009) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871901009 |
| Entity Type | Organization |
| Organization Name | SOUTHEASTERN RECONSTRUCTIVE SERVICES LLC |
| Practice Address |
5205 Frederick St Ste B Savannah GA 31405-4520 |
| Mailing Address |
Po Box 15878 Savannah GA 31416-2578 |
| Practice Telephone | 9123544969 |
| Practice Fax Number | 9123545019 |
| Mailing Telephone | 9123544969 |
| Mailing Fax Number | 9123545019 |
| Enumeration Date | 2014-07-31 |
| Last Update Date | 2014-07-31 |
| Authorized Official Name | LORI WECHSLER (BILLING) |
| Authorized Official Telephone | 9123544969 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
22651 | LA | Allopathic & Osteopathic Physicians |
| Street Address |
5205 FREDERICK ST STE B |
| City | SAVANNAH |
| State | GA |
| Zip Code | 31405-4520 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053918441 | Nicole Marie Tetro | Anesthesiology | Candler Hospital, 5353 Reynolds St, Savannah, GA 31405 | 2020-10-08 |
| 1154983880 | Nickes Medical Supply, LLC. | Durable Medical Equipment & Medical Supplies | 6020 Halsey St, Savannah, GA 31405 | 2019-07-02 |
| 1215593025 | Lee Ann Ryle | Nurse Practitioner | 5223 Paulsen St., Savannah, GA 31405 | 2019-05-16 |
| 1942765334 | Raegan Epps | Behavior Technician | 613 Stephenson Ave Ste 205, Savannah, GA 31405 | 2019-02-10 |
| 1679050454 | Phenomenal Nursing Service | Registered Nurse | 604 South St., 604 South St, Savannah, GA 31405 | 2018-07-24 |
| 1275029472 | Chelsea Amanda Keedy | Pharmacist | 836 E. 65th St., Medical Arts #4, Savannah, GA 31405 | 2018-07-11 |
| 1265933840 | Dwc-p LLC | Dentist | 5209 Paulsen Street, Savannah, GA 31405 | 2018-02-28 |
| 1386153005 | Aaron Shaw | Hearing Instrument Specialist | 5501 Abercorn St Ste E, Savannah, GA 31405 | 2017-09-26 |
| 1063946028 | Elizabeth Bentley Bruhn-danello | Dietitian, Registered | 836 East 65th Street, Medical Arts #4, Savannah, GA 31405 | 2017-04-17 |
| 1396278230 | Theresa Lynn George | Health Educator | 836 East 65 Th Street, Medical Arts #4, Savannah, GA 31405 | 2017-04-07 |
| Find all providers in zip 31405 | ||||
| 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 |
|---|---|---|---|---|
| 1710966866 | John M Searles Jr. | Surgery | 900 Mohawk St Ste E, Savannah, GA 31419 | 2006-01-16 |
| 1598026668 | Patrick J Buchanan | Surgery | 5361 Reynolds St, Savannah, GA 31405 | 2012-06-05 |
| 1699933093 | Matthew D Mcleod | Surgery | 7208 Hodgson Memorial Dr, Savannah, GA 31406-2512 | 2008-06-02 |
| 1073512158 | David Helmar Smith | Surgery | 5361 Reynolds St, Savannah, GA 31405-6014 | 2005-07-20 |
| 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 |
| 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 |
| 1235313776 | Robert William Crow | Surgery | 4400 Harris Valley Rd Nw, Atlanta, GA 30327-3828 | 2007-12-19 |
| 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.