MEDICARE: PLASTIC SURGERY CENTER OF MERIDIAN, LLC

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	261QA1903X	Ambulatory Surgical Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1790714525
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PLASTIC SURGERY CENTER OF MERIDIAN, LLC

Provider Business Mailing Address
First Line	:	11999 SAN VICENTE BLVD
Second Line	:	STE. 440
City	:	LOS ANGELES
State	:	CA
Zip	:	90049-5131
Country	:	US
Telephone Number	:	310-440-3131
Fax Number	:	310-472-9582

Provider Business Practice Location Address
First Line	:	5002 HWY 30 NORTH
Second Line	:	BLDG. D
City	:	MERIDIAN
State	:	MS
Zip	:	39301
Country	:	US
Telephone Number	:	601-481-7070
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. LEE THORTON
Credential	:	M.D.
Telephone Number	:	601-481-7070

Provider Enumeration Date	:	07/02/2006
Last Update Date	:	01/25/2011

Similar Medicare Providers

1740072826 — RONNIE T HOPSON FNP-C
Practice Location Address:

2701 DAVIS ST
MERIDIAN, MS
39301-5708

Practice Phone: 601-693-0118
Practice Fax:

1891642732 — KYAI FORNEY
Practice Location Address:

1314 19TH AVE
MERIDIAN, MS
39301-4116

Practice Phone: 601-483-0011
Practice Fax:

1225983968 — BRASSFIELD GROUP
Practice Location Address:

3128 8TH ST STE D
MERIDIAN, MS
39301-4758

Practice Phone: 205-527-1333
Practice Fax:

1063224467 — MID-MS MEDICAL
Practice Location Address:

3304 8TH ST
MERIDIAN, MS
39301-4755

Practice Phone: 844-225-7160
Practice Fax: 386-343-7195

1730182007 — DR. HARRY DURGIN MD
Practice Location Address:

5002 HIGHWAY 39 N BLDG C
MERIDIAN, MS
39301-1078

Practice Phone: 601-385-9111
Practice Fax: 662-328-1507

1134122484 — DR. JAMES R GREEN SR. MD
Practice Location Address:

2024 15TH ST , STE 4N
MERIDIAN, MS
39301-4130

Practice Phone: 601-693-6663
Practice Fax: 601-693-6665

1861495111 — DR. JAMES R GREEN JR. MD
Practice Location Address:

5002 HIGHWAY 39 N BLDG C
MERIDIAN, MS
39301-1078

Practice Phone: 601-385-9111
Practice Fax: 662-328-1507

Directions to “PLASTIC SURGERY CENTER OF MERIDIAN, LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.