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CENTER FOR PLASTIC SURGERY PC NPI 1417011693


NPI Information

NPI: 1417011693
Provider Name: CENTER FOR PLASTIC SURGERY PC
Classification: Plastic Surgery - 208200000X
Entity Type: Organization
Address:
1844 E 15TH ST
TULSA, OK
ZIP 74104
Phone: (918) 749-7177
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CENTER FOR PLASTIC SURGERY PC is a plastic surgery in Tulsa, OK. The provider is a plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well. CENTER FOR PLASTIC SURGERY PC NPI is 1417011693. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1844 E 15TH ST
TULSA, OK
ZIP 74104-611
Phone: (918) 749-7177
Fax: (918) 749-7309

The provider's authorized official is Mark L. Mathers .
The authorized official title is Physician and has the following contact phone number (918) 749-7177.

The enumeration date for this NPI number is 12/21/2006 and was last updated on 7/7/2010.


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
1208200000XPlastic Surgery2384OKLAHOMAYes

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
1442629711-001OTHEROKLAHOMABLUE CROSS BLUE SHIELD
2=========CMEDICARE ID-TYPE UNSPECIFIEDOKLAHOMA
3100742880AMEDICAIDOKLAHOMA

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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