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General NPI Number Information
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NPI Number | 1841453594
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Entity Type | Organization
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Legal Business Name | OASIS PLASTIC SURGERY, PLLC
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Dates
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Enumeration Date | 07/02/2008
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Last Update Date | 10/17/2008
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Provider Practice Location Address
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Address Line | 9590 E IRONWOOD SQUARE DR SUITE 108
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City | SCOTTSDALE
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State | AZ
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Zip | 85258-4581
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Country | US
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Telephone | 480-264-6428
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Fax | 480-264-6429
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Provider Business Mailing Address
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Address Line | 15029 N THOMPSON PEAK PKWY SUITE B111-603
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City | SCOTTSDALE
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State | AZ
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Zip | 85260-2217
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Country | US
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Telephone | 480-264-6428
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JENNIFER ANN GEOGHEGAN
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Credential | M.D.
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Telephone | 480-264-6428
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number | 36143
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License Number State | AZ
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