Provider Demographics
NPI:1760725139
Name:O'TOOLE PLASTIC SURGERY, PC
Entity Type:Organization
Organization Name:O'TOOLE PLASTIC SURGERY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:P
Authorized Official - Last Name:O'TOOLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:412-345-1615
Mailing Address - Street 1:5830 ELLSWORTH AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15232-1778
Mailing Address - Country:US
Mailing Address - Phone:412-645-1615
Mailing Address - Fax:412-645-1613
Practice Address - Street 1:5830 ELLSWORTH AVENUE
Practice Address - Street 2:SUITE 300
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15232-1300
Practice Address - Country:US
Practice Address - Phone:412-645-1615
Practice Address - Fax:412-645-1613
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-03
Last Update Date:2014-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty