National Provider Identifier Database

ADVANCED PLASTIC RECONSTRUCTION PLLC
Plastic and Reconstructive Surgery


Contact Information

ADVANCED PLASTIC RECONSTRUCTION PLLC
9250 N 3RD ST
SUITE 1003
PHOENIX, AZ85020-2402
Phone: 602-331-7811
Fax: 602-331-5886
Website:
Specialty Taxonomy Code
* Plastic and Reconstructive Surgery 2086S0122X

* Indicates primary specialty

NPI Profile & details for ADVANCED PLASTIC RECONSTRUCTION PLLC

NPI Number 1639330566
Legal business name
LBN
ADVANCED PLASTIC RECONSTRUCTION PLLC
Authorized official PABLO PRICHARD - (OWNER)
Entity Organization
Organization subpart No
Enumeration date 06/23/2008
Last updated 02/27/2018 - About 8 years ago
Sole proprietor1 Not specified
Identifiers
  • AZ Medicaid: 358484
  • Other: Z124156 MEDICARE PTAN

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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