Provider Demographics
NPI:1437775699
Name:SCENIC CITY PLASTIC SURGERY, LLC
Entity Type:Organization
Organization Name:SCENIC CITY PLASTIC SURGERY, LLC
Other - Org Name:SCENIC CITY PLASTIC SURGERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCORD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:423-418-6369
Mailing Address - Street 1:7161 LEE HWY STE 300
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-8609
Mailing Address - Country:US
Mailing Address - Phone:423-418-6369
Mailing Address - Fax:615-235-1300
Practice Address - Street 1:7161 LEE HWY STE 300
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-8609
Practice Address - Country:US
Practice Address - Phone:423-418-6369
Practice Address - Fax:615-235-1300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-23
Last Update Date:2020-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty