NPI 1063604791

Renaissance Plastic Surgery

Organisation Specialist Macon, GA

Practice location

Address: 4030 Riverside Park Blvd, Macon, GA 31210-1365
Phone: (478) 474-2200
Fax: (478) 314-0740

Authorised official

Name: Kathy Stuart
Title: Administrator
Phone: (478) 474-2200

Registered specialties

Specialist Primary

Other Service Providers Taxonomy 174400000X

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Registry record

NPI: 1063604791
Entity type: Organization
NPI issued: 16 Aug 2007
Record last updated: 16 Aug 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.