Provider Demographics
NPI:1760786024
Name:THE GEORGIA CENTER FOR PLASTIC AND RECONSTRUCTIVE SURGERY, PC
Entity Type:Organization
Organization Name:THE GEORGIA CENTER FOR PLASTIC AND RECONSTRUCTIVE SURGERY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:GROVES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:478-254-6608
Mailing Address - Street 1:6326 PEAKE RD
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31210-3960
Mailing Address - Country:US
Mailing Address - Phone:478-254-6608
Mailing Address - Fax:478-254-6689
Practice Address - Street 1:6326 PEAKE RD
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31210-3960
Practice Address - Country:US
Practice Address - Phone:478-254-6608
Practice Address - Fax:478-254-6689
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-30
Last Update Date:2020-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty