# GENESIS PLASTIC SURGERY PC

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

## Provider details

- **NPI number:** 1275808024
- **Authorized official:** FREDERICK E. THOMPSON M.D. (OWNER)
- **Authorized official phone:** (816) 781-3371

## Contact information

- **Practice address:** 100 WESTWOODS DR., LIBERTY, MO 64068-1181
- **Practice address phone:** (816) 781-3371
- **Mailing address:** 100 WESTWOODS DR., LIBERTY, MO 64068-1181
- **Mailing address phone:** (816) 781-3371

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | R8A10 | MO | Yes |

## Other

- **Enumeration date:** 03/13/2012
- **Last updated:** 03/13/2012