Tupelo Plastic Surgery Clinic Of Tupelo Pa

LBN: Tupelo Plastic Surgery Clinic Of Tupelo Pa
Tupelo Plastic Surgery Clinic Of Tupelo Pa is an health care organization with primary practice located at 4381 S Eason Blvd Ste 101 Longtown Medical Park, Tupelo MS 38801-6586. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Plastic Surgery, which is considered as the primary health care specialty. Tupelo Plastic Surgery Clinic Of Tupelo Pa can be contacted via phone (662) 377-6630, or through Buckley, Robert via phone (662) 377-6630.

Contact Information

Primary practice address
4381 S Eason Blvd Ste 101 Longtown Medical Park Tupelo MS 38801-6586
Phone: (662) 377-6630
Fax: (662) 377-6635
Website:
Map and Directions
Authorized official contact:
Name: Buckley, Robert
Phone: (662) 377-6630

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Plastic Surgery 208200000X

Profile Details

NPI number 1649381104
LBN Legal business name Tupelo Plastic Surgery Clinic Of Tupelo Pa
DBA Doing business as
Authorized official Buckley, Robert
Entity Organization
Organization subpart 1 No
Enumeration date Aug 31st, 2006
Last updated Feb 29th, 2008 - about 17 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1649381104 NPPES
Mississippi MEDICAID 00110707

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