Provider Demographics
NPI:1205838018
Name:PLASTIC SURGERY CTR OF NASHVILLE, PLLC
Entity type:Organization
Organization Name:PLASTIC SURGERY CTR OF NASHVILLE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, MEDICAL DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:K
Authorized Official - Last Name:GINGRASS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-467-6777
Mailing Address - Street 1:1915 STATE ST
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-2209
Mailing Address - Country:US
Mailing Address - Phone:615-467-6777
Mailing Address - Fax:615-467-6778
Practice Address - Street 1:1915 STATE ST
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-2209
Practice Address - Country:US
Practice Address - Phone:615-467-6777
Practice Address - Fax:615-467-6778
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-11
Last Update Date:2008-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty