Provider Demographics
NPI:1235184888
Name:PLASTIC SURGERY, P.A.
Entity Type:Organization
Organization Name:PLASTIC SURGERY, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CARROLL
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAHORSKY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:913-888-2225
Mailing Address - Street 1:4701 COLLEGE BLVD
Mailing Address - Street 2:SUITE 206
Mailing Address - City:LEAWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1603
Mailing Address - Country:US
Mailing Address - Phone:913-888-2225
Mailing Address - Fax:913-663-1514
Practice Address - Street 1:4701 COLLEGE BLVD
Practice Address - Street 2:SUITE 206
Practice Address - City:LEAWOOD
Practice Address - State:KS
Practice Address - Zip Code:66211-1603
Practice Address - Country:US
Practice Address - Phone:913-888-2225
Practice Address - Fax:913-663-1514
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSA245802042086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS0002110AMedicare ID - Type Unspecified