Provider Demographics
NPI:1851952253
Name:PLASTIC AND RECONSTRUCTIVE SURGICAL SOLUTIONS
Entity Type:Organization
Organization Name:PLASTIC AND RECONSTRUCTIVE SURGICAL SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SURGEON
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:LOUIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-474-2767
Mailing Address - Street 1:PO BOX 618
Mailing Address - Street 2:
Mailing Address - City:ROYERSFORD
Mailing Address - State:PA
Mailing Address - Zip Code:19468-0618
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:900 HERITAGE DR STE 920
Practice Address - Street 2:
Practice Address - City:SANATOGA
Practice Address - State:PA
Practice Address - Zip Code:19464-9223
Practice Address - Country:US
Practice Address - Phone:610-474-2767
Practice Address - Fax:610-365-4600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-26
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty