Provider Demographics
NPI:1952841447
Name:OPHTHALMIC PLASTIC AND COSMETIC SURGERY, LLC.
Entity Type:Organization
Organization Name:OPHTHALMIC PLASTIC AND COSMETIC SURGERY, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:NEIMKIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:205-222-2611
Mailing Address - Street 1:3280 HOWELL MILL RD NW
Mailing Address - Street 2:SUITE 321
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30327-4111
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3280 HOWELL MILL RD NW
Practice Address - Street 2:SUITE 321
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30327-4111
Practice Address - Country:US
Practice Address - Phone:404-946-8323
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-02
Last Update Date:2017-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA76141207WX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207WX0200XAllopathic & Osteopathic PhysiciansOphthalmologyOphthalmic Plastic and Reconstructive SurgeryGroup - Single Specialty