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General NPI Number Information
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NPI Number | 1841585072
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Entity Type | Organization
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Legal Business Name | SOUTHERN OHIO PLASTIC & RECONSTRUCTIVE SURGICAL INSTITUTE
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Dates
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Enumeration Date | 06/15/2011
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Last Update Date | 01/26/2012
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Provider Practice Location Address
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Address Line | 630 W MAIN ST SUITE 304
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City | WILMINGTON
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State | OH
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Zip | 45177-2170
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Country | US
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Telephone | 937-283-2510
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Fax | 937-283-2513
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Provider Business Mailing Address
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Address Line | 630 W MAIN ST SUITE 304
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City | WILMINGTON
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State | OH
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Zip | 45177-2170
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Country | US
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Telephone | 937-283-2510
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Fax | 937-283-2513
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | DR. SCOTT C. LINDSAY
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Credential | DO
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Telephone | 937-283-2510
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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 | 34.010298
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License Number State | OH
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