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Azalea Center For Plastic Surgery Pc
Specialist in Valdosta, Georgia
NPI 1952431223

Azalea Center For Plastic Surgery Pc is a Specialist based in Valdosta, GA. Azalea Center For Plastic Surgery Pc practices in Valdosta, GA. The NPI Number for Azalea Center For Plastic Surgery Pc is 1952431223 and holds a License No. 39418 (Georgia).

The current practice location address for Azalea Center For Plastic Surgery Pc is 2810 N Oak St, Valdosta, GA and can be reached out via phone at 229-259-0019 and via fax at 229-259-0209.

Location: 2810 N Oak St, Valdosta, GA, 31602-1716
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1952431223
Provider Name
Azalea Center For Plastic Surgery Pc
Credential
Provider Entity Type
Organization
Address
2810 N Oak St, Valdosta, GA, 31602-1716
Phone Number
229-259-0019
Fax Number
229-259-0209
Provider Enumeration Date
03/06/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
110206439 01 GA MEDICARE RR PROVIDER #
598880 01 GA BCBS GA PROVIDER #
00830277A 05 GA
511G700695 01 GA MEDICARE GROUP PIN
institution
Provider Business Practice Location Address Details
Address
2810 N Oak St
City
Valdosta
State
Georgia
Zip
31602-1716
Phone Number
229-259-0019
Fax Number
229-259-0209
person
Provider Business Mailing Address Details
Address
2810 N Oak St
City
Valdosta
State
Georgia
Zip
31602-1716
Phone Number
229-259-0019
Fax Number
229-259-0209
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
39418 (Georgia)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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