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General NPI Number Information
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NPI Number | 1124246822
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Entity Type | Organization
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Legal Business Name | THE PLASTIC SURGERY GROUP
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Dates
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Enumeration Date | 04/20/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3723 HAUCK RD
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City | CINCINNATI
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State | OH
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Zip | 45241-1607
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Country | US
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Telephone | 513-791-4440
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Fax | 513-985-6615
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Provider Business Mailing Address
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Address Line | 3723 HAUCK RD
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City | CINCINNATI
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State | OH
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Zip | 45241-1607
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Country | US
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Telephone | 513-769-3223
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Fax | 513-985-6615
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. JULIE GANDER
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Credential |
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Telephone | 513-791-4440
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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