Provider Demographics
NPI:1073713194
Name:FLANNAGAN PLASTIC SURGERY P.C.
Entity Type:Organization
Organization Name:FLANNAGAN PLASTIC SURGERY P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:FLANNAGAN
Authorized Official - Suffix:
Authorized Official - Credentials:MC
Authorized Official - Phone:812-634-6600
Mailing Address - Street 1:2005 SAINT CHARLES ST
Mailing Address - Street 2:SUITE 4
Mailing Address - City:JASPER
Mailing Address - State:IN
Mailing Address - Zip Code:47546-9146
Mailing Address - Country:US
Mailing Address - Phone:812-634-6600
Mailing Address - Fax:812-634-6621
Practice Address - Street 1:2005 SAINT CHARLES ST
Practice Address - Street 2:SUITE 4
Practice Address - City:JASPER
Practice Address - State:IN
Practice Address - Zip Code:47546-9146
Practice Address - Country:US
Practice Address - Phone:812-634-6600
Practice Address - Fax:812-634-6621
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-18
Last Update Date:2007-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty