Provider Demographics
NPI:1245058114
Name:ALPENAURA PLASTIC SURGERY
Entity type:Organization
Organization Name:ALPENAURA PLASTIC SURGERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN BUSINESS OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOURDAN
Authorized Official - Middle Name:ARISS
Authorized Official - Last Name:CARBOY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:541-762-0262
Mailing Address - Street 1:1382 NE DROST DR
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-3707
Mailing Address - Country:US
Mailing Address - Phone:214-802-8297
Mailing Address - Fax:
Practice Address - Street 1:2275 NE DOCTORS DR STE 1
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-6324
Practice Address - Country:US
Practice Address - Phone:541-762-0262
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-30
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty