Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Ambulatory Surgical |
261QA1903X | 49 | Ambulatory Surgical Center | |
Plastic and Reconstructive Surgery |
2086S0122X | 02 | Physician/General Surgery | |
Plastic Surgery |
208200000X | 02 | Physician/General Surgery | |
Surgery of the Hand |
2086S0105X | 02 | Physician/General Surgery |
| NPI Number | 1669247110 |
| LBN Legal business name | ASTRA PLASTIC SURGERY CENTER, LLC |
| Authorized official | CHRISTOPHER KILLINGSWORTH - (OWNER) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 11/15/2023 |
| Last updated | 04/30/2024 - About 2 years ago |
| Identifiers | n/a |
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