Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | 030330 | GA |
NPI | 1023008794 |
---|---|
Provider Name | Stephen Housman Kahler |
First Address | Carrollton, GA 30117-3857 |
Second Address | Carrollton, GA 30117-4465 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2005 |
Last Update Date | 05/10/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
003154371 | (05) | GA |
E82592 | (02) | GA |