Organization
PLASTIC SURGICAL ARTS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TINA OLIVARES (MANAGER)
(402) 483-2572
Entity
Organization
Contact information
Practice address
4400 LUCILE DR STE 103, LINCOLN, NE 68516-4211
(402) 483-2572
(402) 483-2619
Mailing address
4400 LUCILE DR STE 103, LINCOLN, NE 68516-4211
(402) 483-2572
(402) 483-2619
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CG2908
RAILROAD MEDICARE
—
Enumeration date
07/19/2006
Last updated
10/31/2024
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