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General NPI Number Information
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NPI Number | 1962878553
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Entity Type | Organization
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Legal Business Name | SOUTHEASTERN PLASTIC SURGERY INSTITUTE
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Dates
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Enumeration Date | 08/18/2015
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Last Update Date | 08/18/2015
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Provider Practice Location Address
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Address Line | 2010 PATTON CHAPEL RD SUITE 101
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City | HOOVER
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State | AL
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Zip | 35216-5782
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Country | US
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Telephone | 205-871-3361
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Fax |
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Provider Business Mailing Address
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Address Line | 2010 PATTON CHAPEL RD SUITE 101
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City | HOOVER
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State | AL
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Zip | 35216-5782
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Country | US
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Telephone | 205-871-3361
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. PAUL S. HOWARD
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Credential | MD
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Telephone | 205-871-3361
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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 | AL9373
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License Number State | AL
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