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CENTER FOR PLASTIC & RECONSTRUCTIVE SURGERY PSC NPI 1710084827


NPI Information

NPI: 1710084827
Provider Name: CENTER FOR PLASTIC & RECONSTRUCTIVE SURGERY PSC

Doing Business As: ATALLA PLASTIC SURGERY CENTER

Classification: Surgery - 2086S0122X
Entity Type: Organization

Specialization: Plastic and Reconstructive Surgery

Address:
1048 ASHLEY ST STE 303
BOWLING GREEN, KY
ZIP 42103
Phone: (270) 796-8960
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CENTER FOR PLASTIC & RECONSTRUCTIVE SURGERY PSC is a plastic and reconstructive surgery surgery in Bowling Green, KY. The provider is a surgeon who specializes in plastic and reconstructive surgery. CENTER FOR PLASTIC & RECONSTRUCTIVE SURGERY PSC NPI is 1710084827. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Atalla Plastic Surgery Center.

The provider's business location address is:

1048 ASHLEY ST STE 303
BOWLING GREEN, KY
ZIP 42103-451
Phone: (270) 796-8960
Fax: (270) 842-5683

The provider's authorized official is Fouad V Atalla .
The authorized official title is President/owner and has the following contact phone number (270) 796-8960.

The enumeration date for this NPI number is 9/20/2006 and was last updated on 10/7/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12086S0122XSurgeryPlastic and Reconstructive Surgery33744KENTUCKYNo
22086S0122XSurgeryPlastic and Reconstructive SurgeryYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
165903460MEDICAIDKENTUCKY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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