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Contact Information

PLASTIC AND RECONSTRUCTIVE SURGERY PC
1303 SUNSET DR STE 5
JOHNSON CITY, TN37604-7905
 Phone: 423-328-9000
 Fax: 423-328-9007
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Legal Medicine

173000000X
Indicates primary specialty

NPI Profile & details for PLASTIC AND RECONSTRUCTIVE SURGERY PC

NPI Number 1215167580
LBN Legal business name PLASTIC AND RECONSTRUCTIVE SURGERY PC
Authorized official LAURIE WEBB - (INSURANCE MANAGER)
Entity Organization
Organization subpart 1 No
Enumeration date 07/21/2009
Last updated 11/13/2019 - About 7 years ago
Identifiers
TN License # MD0000025117
TN Medicaid 3081165
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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