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Organization
PLASTIC & RECONSTRUCTIVE SURGERY INC
Active
Organization
PLASTIC & RECONSTRUCTIVE SURGERY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES F JOHNSON MD (PRESIDENT)
(401) 728-7950
Entity
Organization
Contact information
Practice address
333 SCHOOL STREET, SUITE 305, PAWTUCKET, RI 02860
(401) 728-7950
(401) 729-7952
Mailing address
333 SCHOOL STREET, SUITE 305, PAWTUCKET, RI 02860
(401) 728-7950
(401) 729-7952
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001120
BLUE CHIP
RI
01
—
0207928001
CIGNA
—
01
—
1300103
UNITED HEALTHCARE
—
01
—
20624
BLUE CROSS BLUE SHIELD
RI
Enumeration date
09/06/2006
Last updated
08/22/2020
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