PLASTIC SURGERY CENTER, P.A. (NPI# 1063549178) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063549178 |
| Entity Type | Organization |
| Organization Name | PLASTIC SURGERY CENTER, P.A. |
| Practice Address |
1920 Chadwick Dr Suite 108 Jackson MS 39204-3471 |
| Practice Telephone | 6013733730 |
| Mailing Telephone | 6013733730 |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2008-04-20 |
| Authorized Official Name | MRS. DIANA GORMAN (VICE PRES- OFFICE MANAGER) |
| Authorized Official Telephone | 6013733730 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
08261 | MS | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 05959573 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356447825 | Plastic Surgery Center, P.a. | Plastic Surgery | 1861 N Webb Rd, Wichita, KS 67206-3413 | 2006-09-15 |
| 1639253370 | Plastic Surgery Center, P.a. | Plastic Surgery | 1861 N Webb Rd, Wichita, KS 67206-3413 | 2006-10-25 |
| Street Address |
1920 CHADWICK DR SUITE 108 |
| City | JACKSON |
| State | MS |
| Zip Code | 39204-3471 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699856419 | Douglas Edward Gorman Jr. | Plastic Surgery | 1920 Chadwick Dr, Suite 108, Jackson, MS 39204-3471 | 2006-10-18 |
| 1871621052 | Thomas E Ingram | Specialist | 1920 Chadwick Dr, Suite 109, Jackson, MS 39204-3471 | 2007-03-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639797442 | Walk By Faith Not By Sight Homecare | Student in an Organized Health Care Education/Training Program | 2310 Us-80 West, Suite F 1154, Jackson, MS 39204 | 2020-07-08 |
| 1427593888 | Care First Home Care Agency, Inc | In Home Supportive Care | 931 Hwy 80 Suite 2 B-9, Jackson, MS 39204 | 2016-12-21 |
| 1134678808 | Yolonda Kinzie | Registered Nurse | 1134 Winter St., Jackson, MS 39204 | 2016-09-23 |
| 1578983938 | Seaneather Arline Mcgill | Nurse's Aide | 2024 Shady Lane Dr, Jackson, MS 39204 | 2014-04-23 |
| 1942591128 | Real Solutilons, LLC | Exclusive Provider Organization | 831 Hwy 80 W., Jackson, MS 39204 | 2011-04-22 |
| 1548405236 | Visions Physical Therapy | Specialist/Technologist | 4700 Robinson Rd, Jackson, MS 39204 | 2008-12-09 |
| 1588759393 | Donald H Butts | Specialist | 1920 Chadwick Drive, Suite 109, Jackson, MS 39204 | 2006-10-04 |
| 1003907460 | Patrick E Weldon | Psychiatry & Neurology | 1860 Chadwick Drive, Suite 258, Jackson, MS 39204 | 2006-09-28 |
| 1922117662 | Elgin Kenneth Walley | Dentist | 2174 Henry Hill Drive, Jackson, MS 39204 | 2006-08-29 |
| 1376555045 | Linda Nell Hunter | Nurse Practitioner | 1860 Chadwick Dr Ste 150a, Jackson, MS 39204 | 2006-08-12 |
| Find all providers in zip 39204 | ||||
| Taxonomy Code | 2086S0122X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Plastic and Reconstructive Surgery |
| A surgeon who specializes in plastic and reconstructive surgery. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164484796 | Pramit S Malhotra | Surgery | 900 E Michigan Ave, Ste 108, Jackson, MI 49201-2457 | 2006-04-06 |
| 1043872948 | John Magruder Sullivan IIi | Surgery | 2500 N State St, Jackson, MS 39216-4500 | 2019-07-01 |
| 1508352196 | Katherine Christine Benedict | Surgery | 2500 N State St, Jackson, MS 39216-4500 | 2018-07-06 |
| 1780121970 | W.a. Foote Memorial Hospital, Inc | Surgery | 205 N. East Ave, Jackson, MI 49201 | 2017-01-25 |
| 1437386232 | Emily T Wolfe | Surgery | 87 Murray Guard Dr Ste B, Jackson, TN 38305-3775 | 2009-06-18 |
| 1598979064 | Peter B Arnold | Surgery | 2500 N State St, Jackson, MS 39216-4500 | 2007-05-10 |
| 1316071145 | John C Payne | Surgery | 555 E Broadway, Suite 211, Jackson, WY 83001 | 2007-03-15 |
| 1538244579 | John Barry Mccraw | Surgery | 2500 N State St, Jackson, MS 39216-4500 | 2006-10-26 |
| 1073695706 | William C Lineaweaver | Surgery | 1850 Chadwick Dr Ste 1427, North Tower, 4 West, Jackson, MS 39204-3404 | 2006-10-20 |
| 1699730150 | George Eli Howell II | Surgery | 971 Lakeland Dr, Suite 315, Jackson, MS 39216-4643 | 2006-04-19 |
| Find all providers in JACKSON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.