SOUTHEASTERN PLASTIC SURGERY ASSOC. PC NPI 1124168927

NPI Information

  • NPI: 1124168927
  • Provider Name: SOUTHEASTERN PLASTIC SURGERY ASSOC., PC
  • Classification: Specialist - 174400000X
  • Entity Type: Organization
  • Address: 100 TOWNCENTER
    SUITE 111
    TUSCALOOSA, AL
    ZIP 35406
  • Phone: (205) 345-8820

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NPI Details

SOUTHEASTERN PLASTIC SURGERY ASSOC., PC is a specialist in Tuscaloosa, AL. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. SOUTHEASTERN PLASTIC SURGERY ASSOC., PC NPI is 1124168927. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

100 TOWNCENTER
SUITE 111
TUSCALOOSA, AL
ZIP 35406-832
Phone: (205) 345-8820
Fax: (205) 345-8842

The provider's authorized official is Luis R Pernia .
The authorized official title is Surgeon and has the following contact phone number (205) 345-8820.

The enumeration date for this NPI number is 2/8/2007 and was last updated on 3/27/2012.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1174400000XSpecialist10631ALABAMAYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1441666528BOTHERMISSISSIPPIBCBS OF MS
2528501310MEDICAIDALABAMA
351014573OTHERALABAMABCBS OF AL
4C75693MEDICARE UPINALABAMA
5000014573MEDICARE ID-TYPE UNSPECIFIEDALABAMA
6240000037OTHERMISSISSIPPIMEDICARE

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: 3/30/2025

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