Provider Demographics
NPI:1457645095
Name:HSV PLASTIC SURGERY PC
Entity Type:Organization
Organization Name:HSV PLASTIC SURGERY PC
Other - Org Name:WILSON PLASTIC SURGERY
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:M.D./OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:C
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:256-551-2002
Mailing Address - Street 1:805 MADISON ST SE
Mailing Address - Street 2:SUITE A
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-4419
Mailing Address - Country:US
Mailing Address - Phone:256-551-2002
Mailing Address - Fax:
Practice Address - Street 1:805 MADISON ST SE
Practice Address - Street 2:SUITE A
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-4419
Practice Address - Country:US
Practice Address - Phone:256-551-2002
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-31
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL307742086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty