Provider Demographics
NPI:1033311949
Name:PREMIER PLASTIC SURGERY ARTS PA
Entity Type:Organization
Organization Name:PREMIER PLASTIC SURGERY ARTS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:FRANCKLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:856-772-6500
Mailing Address - Street 1:PO BOX 1225
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-7225
Mailing Address - Country:US
Mailing Address - Phone:856-772-6500
Mailing Address - Fax:856-772-6505
Practice Address - Street 1:2301 E EVESHAM RD
Practice Address - Street 2:SUITE 107
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-4501
Practice Address - Country:US
Practice Address - Phone:856-772-6500
Practice Address - Fax:856-772-6505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-03
Last Update Date:2012-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ069853Medicare PIN