# FACIAL PLASTIC SURGERY EARS, NOSE, AND THROAT CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043404296
- **Authorized official:** DR. BANIPAL HOVHANESSIAN MD (DR./OWNER)
- **Authorized official phone:** (765) 455-2577

## Contact information

- **Practice address:** 2220 W ALTO RD, KOKOMO, IN 46902-4840
- **Practice address phone:** (765) 455-2577
- **Mailing address:** 2220 W ALTO RD, KOKOMO, IN 46902-4840
- **Mailing address phone:** (765) 455-2577

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207YS0123X | Facial Plastic Surgery Physician | — | NULL | — |
| 207YS0123X | Facial Plastic Surgery Physician | — | — | — |
| 207YX0007X | Plastic Surgery within the Head & Neck (Otolaryngology) Physician | — | NULL | Yes |
| 207YX0007X | Plastic Surgery within the Head & Neck (Otolaryngology) Physician | — | — | Yes |
| 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