# GREENVILLE FACIAL PLASTIC SURGERY, LLC

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

## Provider details

- **NPI number:** 1073224416
- **Authorized official:** KATHERINE HICKS MD (PHYSICIAN/OWNER)
- **Authorized official phone:** (864) 990-4240

## Contact information

- **Practice address:** 107 MILLS AVE, GREENVILLE, SC 29605-4017
- **Practice address phone:** (864) 990-4240
- **Mailing address:** 37 DOUGLAS DR, GREENVILLE, SC 29605-1207
- **Mailing address phone:** (864) 275-8333

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 12/07/2022
- **Last updated:** 12/07/2022