TRIAD OCULAR AND FACIAL PLASTIC SURGERY PLLC (NPI# 1245737568) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245737568 |
| Entity Type | Organization |
| Organization Name | TRIAD OCULAR AND FACIAL PLASTIC SURGERY PLLC |
| Practice Address |
122 E Kinderton Way # B Bermuda Run NC 27006-7303 |
| Mailing Address |
5335 Robinhood Village Dr # 178 Winston Salem NC 27106-9820 |
| Practice Telephone | 3364483060 |
| Practice Fax Number | 3369983333 |
| Mailing Telephone | 3364483060 |
| Enumeration Date | 2018-04-12 |
| Last Update Date | 2019-04-05 |
| Authorized Official Name | MOLLY LYNN FULLER (OWNER) |
| Authorized Official Telephone | 3364483060 |
| Authorized Official Credential | MD, PHD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2082S0099X |
Plastic Surgery Specialization: Plastic Surgery Within the Head and Neck |
2015-01115 | NC | Allopathic & Osteopathic Physicians |
| Y | 207WX0200X |
Ophthalmology Specialization: Ophthalmic Plastic and Reconstructive Surgery |
2015-01115 | NC | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 225 East Lee Avenue, Yadkinville, NC 270557807 | 3364483060 | 3369983333 |
| 2 Hospital Dr, Lexington, NC 272926781 | 3364483060 | 3369983333 |
| Street Address |
122 E KINDERTON WAY # B |
| City | BERMUDA RUN |
| State | NC |
| Zip Code | 27006-7303 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942811567 | Venessa Brunt | Home Health | 271 Orchard Park Drive, Advance, NC 27006 | 2020-08-17 |
| 1730707928 | Dara Elzena Green | Physical Therapist | 142 Hollybrook Dr, Advance, NC 27006 | 2020-07-14 |
| 1104339084 | Mark Curry Maynard | Registered Nurse | 125 W Robin Dr, Advance, NC 27006 | 2017-11-14 |
| 1457781585 | Christa Cook | Physical Therapist | 316 N Carolina 801, Advance, NC 27006 | 2013-11-27 |
| 1801029582 | Bonnie T. Bergen | Pharmacist | 260 Us Hwy 801 N, Advance, NC 27006 | 2009-08-28 |
| 1073745485 | Digestive Health Specialists, Pa | Internal Medicine | 112 Kinderton Blvd, Advance, NC 27006 | 2009-08-18 |
| 1114101078 | Dr. Todd Carter D.d.s | Dentist | 123 Nc Highway 801 S. #c-100, Advance, NC 27006 | 2007-12-27 |
| 1437373883 | Adam T. Dorsett | Dentist | 127 Royal Troon Ln, Advance, NC 27006 | 2007-04-13 |
| 1861583882 | Todd H Carter | Dentist | 123 Nc Hwy 801 South, C-100, Advance, NC 27006 | 2006-09-27 |
| 1104927987 | Eckerd Corporation | Durable Medical Equipment & Medical Supplies | 260 Highway 801, Advance, NC 27006 | 2006-09-26 |
| Find all providers in zip 27006 | ||||
| Taxonomy Code | 207WX0200X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| Specialization | Ophthalmic Plastic and Reconstructive Surgery |
| A physician who specializes in oculofacial plastic and reconstructive surgery. This subspecialty combines orbital and periocular surgery with facial plastic surgery, and includes aesthetic and reconstructive surgery of the face, orbit, eyelid, and lacrimal system. Practitioners evaluate, diagnose and treat conditions involving the eyelids, brows, midface, orbits, lacrimal systems and surrounding and supporting structures of the face and neck. |
| Notes: Source: American Academy of Ophthalmology, 2015. www.aao.org [1/1/2016: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346535283 | Oculofacial Plastic Surgery Consultants Pa | Ophthalmology | 3731 Nw Cary Pkwy Ste 101, Cary, NC 27513 | 2011-06-17 |
| 1023546876 | Raleigh Ophthalmic Associates | Ophthalmology | 2709 Blue Ridge Rd Ste 100, Raleigh, NC 27607-6462 | 2017-05-24 |
| 1285856690 | Aesthetic Facial & Ocular Plastic Surgery Center, Pa | Ophthalmology | 2047 Valleygate Dr, Fayetteville, NC 28304-3688 | 2007-05-03 |
| City | BERMUDA RUN |
| Zip Code | 27006 |
Please comment or provide details below to improve the information on TRIAD OCULAR AND FACIAL PLASTIC SURGERY PLLC.
| 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.