MEDICARE: RICHMOND PLASTIC SURGEONS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208200000X	Plastic Surgery Physician

General Provider Information

NPI Number	:	1265523054
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RICHMOND PLASTIC SURGEONS

Provider Business Mailing Address
First Line	:	14401 SOMMERVILLE CT
Second Line	:
City	:	MIDLOTHIAN
State	:	VA
Zip	:	23113-6836
Country	:	US
Telephone Number	:	804-285-4115
Fax Number	:

Provider Business Practice Location Address
First Line	:	1630 WILKES RIDGE PKWY STE 201
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23233-7460
Country	:	US
Telephone Number	:	804-285-4115
Fax Number	:

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	LEWIS T LADOCSI
Credential	:	MD
Telephone Number	:	804-285-4115

Provider Enumeration Date	:	09/27/2006
Last Update Date	:	11/28/2018

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Directions to “RICHMOND PLASTIC SURGEONS ” Practice Location

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