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TRIAD OCULAR AND FACIAL PLASTIC SURGERY PLLC NPI 1245737568


NPI Information

NPI: 1245737568
Provider Name: TRIAD OCULAR AND FACIAL PLASTIC SURGERY PLLC
Classification: Ophthalmology - 207WX0200X
Entity Type: Organization

Specialization: Ophthalmic Plastic and Reconstructive Surgery

CLIA Number: 34D2299956

Address:
122 E KINDERTON WAY # B
BERMUDA RUN, NC
ZIP 27006
Phone: (336) 448-3060
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TRIAD OCULAR AND FACIAL PLASTIC SURGERY PLLC is an ophthalmic plastic and reconstructive surgery ophthalmology in Bermuda Run, NC. The provider is 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. TRIAD OCULAR AND FACIAL PLASTIC SURGERY PLLC NPI is 1245737568. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

122 E KINDERTON WAY # B
BERMUDA RUN, NC
ZIP 27006-303
Phone: (336) 448-3060
Fax: (336) 998-3333

The provider's authorized official is Molly Lynn Fuller .
The authorized official title is Owner and has the following contact phone number (336) 448-3060.

The CLIA number assigned to this NPI record is 34D2299956 - other - offic based surgery cente with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/12/2018 and was last updated on 4/5/2019.


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
12082S0099XPlastic SurgeryPlastic Surgery Within the Head and Neck2015-01115NORTH CAROLINANo
2207WX0200XOphthalmologyOphthalmic Plastic and Reconstructive Surgery2015-01115NORTH CAROLINAYes

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: 5/5/2024

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