Healthcare Provider Details

I. General information

NPI: 1437764040
Provider Name (Legal Business Name): ESKRA PLASTIC SURGERY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2020
Last Update Date: 09/10/2020
Certification Date: 09/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 INNOVATION WAY
KINSTON NC
28504-7619
US

IV. Provider business mailing address

1001 INNOVATION WAY
KINSTON NC
28504-7619
US

V. Phone/Fax

Practice location:
  • Phone: 919-587-4400
  • Fax:
Mailing address:
  • Phone: 919-587-4400
  • 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: DR. BENJAMIN D ESKRA
Title or Position: MD/OWNER
Credential:
Phone: 919-587-4400