Provider Demographics
NPI:1841453594
Name:OASIS PLASTIC SURGERY, PLLC
Entity type:Organization
Organization Name:OASIS PLASTIC SURGERY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:GEOGHEGAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-264-6428
Mailing Address - Street 1:15029 N THOMPSON PEAK PKWY
Mailing Address - Street 2:SUITE B111-603
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-2217
Mailing Address - Country:US
Mailing Address - Phone:480-264-6428
Mailing Address - Fax:
Practice Address - Street 1:9590 E IRONWOOD SQUARE DR
Practice Address - Street 2:SUITE 108
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-4581
Practice Address - Country:US
Practice Address - Phone:480-264-6428
Practice Address - Fax:480-264-6429
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-02
Last Update Date:2008-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ361432086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty