| NPI | 1093255044 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FREDERICK LETOIS DURDEN Physician 404-642-7722 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: GA 65539) |
| Enumeration Date | 2017-02-24 |
| Last Update Date | 2017-02-24 |