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Contact Information

RENAISSANCE PLASTIC SURGERY PLLC
2601 KENTUCKY AVE
STE 401
PADUCAH, KY42003-3827
 Phone: 270-444-8200
 Fax: 270-444-8398
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Plastic Surgery

208200000X 02 Physician/General Surgery
 

Plastic and Reconstructive Surgery

2086S0122X 02 Physician/General Surgery
 

Surgery of the Hand

2086S0105X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for RENAISSANCE PLASTIC SURGERY PLLC

NPI # 1154342350
LBN Legal business name RENAISSANCE PLASTIC SURGERY PLLC
Authorized official DANIEL TKACH - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 07/22/2006
Last updated 12/03/2010 - About 16 years ago
Identifiers
KY Medicaid 65907685
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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