NORTH STAR PLASTIC SURGERY LLC; NPI #1417653569

Contact Information

NORTH STAR PLASTIC SURGERY LLC

1919 LATHROP ST STE 205
FAIRBANKS, AK 99701-5942

Phone: 907-416-5611
Fax:
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Plastic and Reconstructive Surgery	2086S0122X	02	Physician/General Surgery

Indicates primary specialty

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NPI Profile & details for NORTH STAR PLASTIC SURGERY LLC

NPI # 1417653569

LBN Legal business name NORTH STAR PLASTIC SURGERY LLC

Authorized official ERICK MARTELL - (OWNER)

Entity Organization

Organization subpart ¹ No

Enumeration date 01/31/2023

Last updated 09/13/2023 - About 3 years ago

Identifiers

Medicaid

1720992

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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