Healthcare Provider Details

I. General information

NPI: 1902837743
Provider Name (Legal Business Name): LOUISVILLE PLASTIC SURGERY CONSULTANTS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6400 DUTCHMANS PKWY SUITE 205
LOUISVILLE KY
40205-3340
US

IV. Provider business mailing address

6400 DUTCHMANS PKWY SUITE 205
LOUISVILLE KY
40205-3340
US

V. Phone/Fax

Practice location:
  • Phone: 502-314-4866
  • Fax:
Mailing address:
  • Phone: 502-314-4866
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: RAMSEY KEVEN MAJZOUB
Title or Position: OWNER
Credential: MD
Phone: 502-314-4866