Healthcare Provider Details

I. General information

NPI: 1548586100
Provider Name (Legal Business Name): ARTISTIC SURGICAL ASSOCIATES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2010
Last Update Date: 04/07/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1567 S COUNTY TRL
EAST GREENWICH RI
02818-1695
US

IV. Provider business mailing address

1567 S COUNTY TRL
EAST GREENWICH RI
02818-1695
US

V. Phone/Fax

Practice location:
  • Phone: 401-541-7170
  • Fax: 401-541-7175
Mailing address:
  • Phone: 401-541-7170
  • Fax: 401-541-7175

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2082S0099X
TaxonomyPlastic Surgery Within the Head and Neck (Plastic Surgery) Physician
License Number07729
License Number StateRI

VIII. Authorized Official

Name: DR. CURTIS JOHN PERRY
Title or Position: OWNER
Credential: M.D.
Phone: 401-541-7170