Provider Demographics
NPI:1639706328
Name:NIP & TUCK PLASTIC SURGERY LLC
Entity Type:Organization
Organization Name:NIP & TUCK PLASTIC SURGERY LLC
Other - Org Name:NIJ LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-777-8825
Mailing Address - Street 1:3280 HOWELL MILL RD NW STE 200
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30327-4100
Mailing Address - Country:US
Mailing Address - Phone:404-777-8825
Mailing Address - Fax:706-400-4422
Practice Address - Street 1:3280 HOWELL MILL RD NW STE 200
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30327-4100
Practice Address - Country:US
Practice Address - Phone:404-777-8825
Practice Address - Fax:706-400-4422
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-24
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty