Provider Demographics
NPI:1609861525
Name:PLASTIC SURGERY INC
Entity Type:Organization
Organization Name:PLASTIC SURGERY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:BISHOP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-242-0590
Mailing Address - Street 1:40 MEDICAL PARK
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003-6392
Mailing Address - Country:US
Mailing Address - Phone:304-242-0590
Mailing Address - Fax:304-242-9740
Practice Address - Street 1:40 MEDICAL PARK
Practice Address - Street 2:SUITE 200
Practice Address - City:WHEELING
Practice Address - State:WV
Practice Address - Zip Code:26003-6392
Practice Address - Country:US
Practice Address - Phone:304-242-0590
Practice Address - Fax:304-242-9740
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-16
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVCA0252OtherRAILROAD MEDICARE
OHCA0252OtherRAILROAD MEDICARE
OHCA0252OtherRAILROAD MEDICARE
OH9916713Medicare PIN