Provider Demographics
NPI:1932312592
Name:COLLINS & FRANKLIN PLASTIC SURGERY
Entity Type:Organization
Organization Name:COLLINS & FRANKLIN PLASTIC SURGERY
Other - Org Name:CAROLINA PLASTIC SURGERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MD/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:STEWART
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:919-510-5130
Mailing Address - Street 1:8300 HEALTH PARK
Mailing Address - Street 2:STE 205
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-4731
Mailing Address - Country:US
Mailing Address - Phone:919-510-5130
Mailing Address - Fax:919-803-5380
Practice Address - Street 1:8300 HEALTH PARK
Practice Address - Street 2:STE 205
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-4731
Practice Address - Country:US
Practice Address - Phone:919-510-5130
Practice Address - Fax:919-803-5380
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-08
Last Update Date:2015-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2005-00353208200000X
NC2003-00784208200000X
2086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Multi-Specialty
No2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC140Y5OtherBCBS
NC9858468OtherCINGA
NC189450OtherMEDCOST
NC2558427OtherUNITEDHEALTH CARE
NC7419727OtherAETNA
NC9399806OtherPHCS