Provider Demographics
NPI:1679885164
Name:HARRINGTON PLASTIC SURGERY, PA
Entity Type:Organization
Organization Name:HARRINGTON PLASTIC SURGERY, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:KAYE
Authorized Official - Last Name:MATSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-290-7600
Mailing Address - Street 1:7373 FRANCE AVE S
Mailing Address - Street 2:510
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-4534
Mailing Address - Country:US
Mailing Address - Phone:651-290-7600
Mailing Address - Fax:
Practice Address - Street 1:7373 FRANCE AVE S
Practice Address - Street 2:510
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-4534
Practice Address - Country:US
Practice Address - Phone:651-290-7600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-13
Last Update Date:2010-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN379882086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1300076OtherMEDICA
MN01024742OtherPREFERRED ONE
MN22D40HAOtherBLUE CROSS BLUE SHIELD
MN70193OtherHEALTHPARTNERS
MN709325000Medicaid
MN1300076OtherMEDICA
MNG09421Medicare UPIN