Provider Demographics
NPI:1144460510
Name:PRECISION HAND AND RECONSTRUCTIVE SURGERY
Entity type:Organization
Organization Name:PRECISION HAND AND RECONSTRUCTIVE SURGERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CYRIL
Authorized Official - Middle Name:FRANKLYN
Authorized Official - Last Name:HALBERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-789-9240
Mailing Address - Street 1:PO BOX 11546
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30355-1546
Mailing Address - Country:US
Mailing Address - Phone:678-789-9240
Mailing Address - Fax:770-491-8917
Practice Address - Street 1:2801 N DECATUR RD
Practice Address - Street 2:SUITE 395
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-5949
Practice Address - Country:US
Practice Address - Phone:678-789-9240
Practice Address - Fax:770-491-8917
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-25
Last Update Date:2009-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0425932086S0105X, 2086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Multi-Specialty
No2086S0105XAllopathic & Osteopathic PhysiciansSurgerySurgery of the HandGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000837559AMedicaid
GAF91376Medicare UPIN