Provider Demographics
NPI:1174614416
Name:PLASTIC SURGERY ASSOCIATES OF LYNCHBURG, INC.
Entity type:Organization
Organization Name:PLASTIC SURGERY ASSOCIATES OF LYNCHBURG, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:L
Authorized Official - Last Name:BLANCHETTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-384-6974
Mailing Address - Street 1:1330 OAK LN
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24503-2513
Mailing Address - Country:US
Mailing Address - Phone:434-384-0610
Mailing Address - Fax:434-384-1074
Practice Address - Street 1:1330 OAK LN
Practice Address - Street 2:SUITE 100
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24503-2513
Practice Address - Country:US
Practice Address - Phone:434-384-0610
Practice Address - Fax:434-384-1074
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2012-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty