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Contact Information

BESPOKE AESTHETICS AND PLASTIC SURGERY
161 MONTGOMERY ST STE C
MADISON, MS39110-1119
 Phone: 601-987-6581
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Plastic Surgery

208200000X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for BESPOKE AESTHETICS AND PLASTIC SURGERY

NPI # 1417783317
LBN Legal business name BESPOKE AESTHETICS AND PLASTIC SURGERY
Authorized official ERICA BASS - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 09/09/2024
Last updated 10/30/2025 - About 7 months ago
Identifiers n/a
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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