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PURA PLASTIC SURGERY

Physicians - Surgery Plastic and Reconstructive Surgery

Lexington, South Carolina

Provider NPI: 1447619218

Organization Information:
Organization Name:  PURA PLASTIC SURGERY


Practice Location:
5351 SUNSET BLVD  LEXINGTON, SC 29072 US
Tel: 803-490-7644  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N207YX0905XPhysicians
Otolaryngology
Otolaryngology/Facial Plastic Surgery
SC33186
N2086S0105XPhysicians
Surgery
SC33186
N207ND0101XPhysicians
Dermatology
SC33186
N207YX0602XPhysicians
Otolaryngology
SC33186
N208200000XPhysicians
Plastic Surgery
SC33186
Y2086S0122XPhysicians
Surgery
SC33186

Other Provider Identifiers:

IssuerNumberStateType
331867SC05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin



RECONSTRUCTIVE SURGERY JOBS SC - Page 1



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