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Organization
FACIAL PLASTIC SURGERY EARS, NOSE, AND THROAT CLINIC
Active
Organization
FACIAL PLASTIC SURGERY EARS, NOSE, AND THROAT CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BANIPAL HOVHANESSIAN MD (DR./OWNER)
(765) 455-2577
Entity
Organization
Contact information
Practice address
2220 W ALTO RD, KOKOMO, IN 46902-4840
(765) 455-2577
Mailing address
2220 W ALTO RD, KOKOMO, IN 46902-4840
(765) 455-2577
Taxonomy
Speciality
Code
Description
License number
State
207YS0123X
Facial Plastic Surgery Physician
—
NULL
207YS0123X
Facial Plastic Surgery Physician
—
—
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
Primary
—
NULL
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
Primary
—
—
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
—
NULL
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
—
—
2082S0099X
Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
—
NULL
2082S0099X
Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
—
—
Other
Enumeration date
08/30/2007
Last updated
08/30/2007
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