Healthcare Provider Details

I. General information

NPI: 1548275233
Provider Name (Legal Business Name): NEW HORIZONS PLASTIC SURGERY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27961 US HIGHWAY 98
DAPHNE AL
36526-4702
US

IV. Provider business mailing address

27961 US HIGHWAY 98
DAPHNE AL
36526-4702
US

V. Phone/Fax

Practice location:
  • Phone: 228-324-3750
  • Fax:
Mailing address:
  • Phone: 228-324-3750
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number983956
License Number StateAL

VIII. Authorized Official

Name: DR. HAROLD J WEBB
Title or Position: OWNER
Credential: MD
Phone: 228-324-3750