Provider Demographics
NPI:1073101655
Name:PLASTIC SURGERY CLINIC OF EC, S.C.
Entity Type:Organization
Organization Name:PLASTIC SURGERY CLINIC OF EC, S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:EMBER
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:EWINGS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:715-833-2116
Mailing Address - Street 1:3221 STEIN BLVD STE 2
Mailing Address - Street 2:
Mailing Address - City:EAU CLAIRE
Mailing Address - State:WI
Mailing Address - Zip Code:54701-4399
Mailing Address - Country:US
Mailing Address - Phone:715-833-2116
Mailing Address - Fax:715-833-1068
Practice Address - Street 1:1220 3RD AVE W
Practice Address - Street 2:
Practice Address - City:DURAND
Practice Address - State:WI
Practice Address - Zip Code:54736-1600
Practice Address - Country:US
Practice Address - Phone:715-672-4211
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-08
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty