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General NPI Number Information
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NPI Number | 1205838018
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Entity Type | Organization
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Legal Business Name | PLASTIC SURGERY CTR OF NASHVILLE, PLLC
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Dates
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Enumeration Date | 08/11/2005
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Last Update Date | 05/12/2008
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Provider Practice Location Address
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Address Line | 1915 STATE ST
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City | NASHVILLE
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State | TN
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Zip | 37203-2209
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Country | US
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Telephone | 615-467-6777
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Fax | 615-467-6778
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Provider Business Mailing Address
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Address Line | 1915 STATE ST
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City | NASHVILLE
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State | TN
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Zip | 37203-2209
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Country | US
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Telephone | 615-467-6777
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Fax | 615-467-6778
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Authorized Official
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Title or Position | OWNER, MEDICAL DOCTOR
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Name | MARY K. GINGRASS
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Credential | M.D.
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Telephone | 615-467-6777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number |
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License Number State |
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