National Provider Identifier Database

CENTER FOR PLASTIC RECONSTRUCTIVE SURGERY PSC
Plastic and Reconstructive Surgery


Contact Information

CENTER FOR PLASTIC & RECONSTRUCTIVE SURGERY PSC
1048 ASHLEY ST STE 303
BOWLING GREEN, KY42103-2451
Phone: 270-796-8960
Fax: 270-842-5683
Website:
Specialty Taxonomy Code
* Plastic and Reconstructive Surgery 2086S0122X

* Indicates primary specialty

NPI Profile & details for CENTER FOR PLASTIC & RECONSTRUCTIVE SURGERY PSC

NPI Number 1710084827
Legal business name
LBN
CENTER FOR PLASTIC & RECONSTRUCTIVE SURGERY PSC
Authorized official FOUAD ATALLA - (PRESIDENT/OWNER)
Entity Organization
Organization subpart No
Enumeration date 09/20/2006
Last updated 10/07/2020 - About 6 years ago
Sole proprietor1 Not specified
Identifiers
  • KY License #: 33744
  • KY Medicaid: 65903460

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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