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MILE HIGH PLASTIC SURGERY A PROFESSIONAL LLC NPI 1982978797


NPI Information

NPI: 1982978797
Provider Name: MILE HIGH PLASTIC SURGERY A PROFESSIONAL LLC

Doing Business As: MILE HIGH PLASTIC SURGERY

Classification: Plastic Surgery - 208200000X
Entity Type: Organization
Address:
2595 CANYON BLVD STE 360
BOULDER, CO
ZIP 80302
Phone: (303) 440-7546
Get Directions

MILE HIGH PLASTIC SURGERY A PROFESSIONAL LLC is a plastic surgery in Boulder, CO. 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. MILE HIGH PLASTIC SURGERY A PROFESSIONAL LLC NPI is 1982978797. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Mile High Plastic Surgery.

The provider's business location address is:

2595 CANYON BLVD STE 360
BOULDER, CO
ZIP 80302-745
Phone: (303) 440-7546

The provider's authorized official is Nathan Roesner .
The authorized official title is Sole Member and has the following contact phone number (303) 552-1996.

The enumeration date for this NPI number is 2/27/2012 and was last updated on 10/20/2021.


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 SurgeryDR-50492COLORADOYes

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
197705578MEDICAIDCOLORADO

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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