Provider Demographics
NPI:1467910737
Name:SARKOS PLASTIC SURGERY LLC
Entity Type:Organization
Organization Name:SARKOS PLASTIC SURGERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:SARKOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:234-244-4251
Mailing Address - Street 1:2662 ELM RD BLDG C
Mailing Address - Street 2:
Mailing Address - City:CORTLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44410-9393
Mailing Address - Country:US
Mailing Address - Phone:234-244-4251
Mailing Address - Fax:234-244-8218
Practice Address - Street 1:2662 ELM RD BLDG C
Practice Address - Street 2:
Practice Address - City:CORTLAND
Practice Address - State:OH
Practice Address - Zip Code:44410-9393
Practice Address - Country:US
Practice Address - Phone:234-244-4251
Practice Address - Fax:234-244-8218
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-06
Last Update Date:2019-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty