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General NPI Number Information
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NPI Number | 1578793378
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Entity Type | Organization
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Legal Business Name | HANKINS PLASTIC SURGERY ASSOCIATES
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Dates
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Enumeration Date | 07/15/2009
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Last Update Date | 07/15/2009
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Provider Practice Location Address
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Address Line | 9053 S PECOS RD STE 3000
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City | HENDERSON
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State | NV
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Zip | 89074-7179
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Country | US
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Telephone | 928-854-5400
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Fax |
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Provider Business Mailing Address
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Address Line | 2010 INJO DR
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City | LAKE HAVASU CITY
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State | AZ
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Zip | 86403-5707
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Country | US
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Telephone | 928-854-5400
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Fax | 928-854-5401
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | WARREN TRACY HANKINS
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Credential | MD
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Telephone | 928-854-5400
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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 | 10829
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License Number State | NV
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