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General NPI Number Information
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NPI Number | 1396892790
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Entity Type | Organization
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Legal Business Name | PLASTIC SURGERY SPECIALISTS, PC
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Dates
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Enumeration Date | 01/05/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2525 N 8TH ST STE 203
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City | GRAND JUNCTION
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State | CO
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Zip | 81501-8847
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Country | US
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Telephone | 970-242-9127
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Fax | 970-242-8304
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Provider Business Mailing Address
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Address Line | 2525 N 8TH ST STE 203
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City | GRAND JUNCTION
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State | CO
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Zip | 81501-8847
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Country | US
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Telephone | 970-242-9127
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Fax | 970-242-8304
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. WILLIAM DOYLE MERKEL
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Credential | MD
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Telephone | 970-242-9127
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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 | 16074
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License Number State | CO
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