# PLASTIC SURGERY ASSOCIATES OF MONTGOMERY

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

## Provider details

- **NPI number:** 1417372749
- **Authorized official:** DR. MICHAEL P BENTLEY M.D. (SURGEON/PRESIDENT)
- **Authorized official phone:** (334) 284-2800

## Contact information

- **Practice address:** 6727 TAYLOR CT, MONTGOMERY, AL 36117-7708
- **Practice address phone:** (334) 284-2800
- **Practice address fax:** (334) 284-0438
- **Mailing address:** 6727 TAYLOR CT, MONTGOMERY, AL 36117-7708
- **Mailing address phone:** (334) 284-2800
- **Mailing address fax:** (334) 284-0438

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 12411 | AL | — |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 12601 | AL | Yes |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 14727 | AL | — |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 24023 | AL | — |
| 261QM2500X | Medical Specialty Clinic/Center | 12411 | AL | — |
| 261QM2500X | Medical Specialty Clinic/Center | 12601 | AL | — |
| 261QM2500X | Medical Specialty Clinic/Center | 14727 | AL | — |
| 261QM2500X | Medical Specialty Clinic/Center | 24023 | AL | — |

## Other

- **Enumeration date:** 02/24/2014
- **Last updated:** 02/24/2014