Provider Demographics
NPI:1942892237
Name:PLASTIC SURGEONS OF AKRON LLC
Entity Type:Organization
Organization Name:PLASTIC SURGEONS OF AKRON LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:PEDERSEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-351-0300
Mailing Address - Street 1:270 S CLEVELAND MASSILLON RD STE C
Mailing Address - Street 2:
Mailing Address - City:FAIRLAWN
Mailing Address - State:OH
Mailing Address - Zip Code:44333-6000
Mailing Address - Country:US
Mailing Address - Phone:330-443-0221
Mailing Address - Fax:330-303-1880
Practice Address - Street 1:270 S CLEVELAND MASSILLON RD STE C
Practice Address - Street 2:
Practice Address - City:FAIRLAWN
Practice Address - State:OH
Practice Address - Zip Code:44333-6000
Practice Address - Country:US
Practice Address - Phone:330-443-0221
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-08
Last Update Date:2021-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty