Organization
SOUTHEASTERN PLASTIC SURGERY ASSOC., PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LUIS R PERNIA M.D. (SURGEON)
(205) 345-8820
Entity
Organization
Contact information
Practice address
100 TOWNCENTER, SUITE 111, TUSCALOOSA, AL 35406-1832
(205) 345-8820
(205) 345-8842
Mailing address
100 TOWNCENTER, SUITE 111, TUSCALOOSA, AL 35406-1832
(205) 345-8820
(205) 345-8842
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
10631
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
240000037
MEDICARE
MS
01
—
441666528B
BCBS OF MS
MS
01
—
51014573
BCBS OF AL
AL
05
—
528501310
—
AL
Enumeration date
02/08/2007
Last updated
09/25/2025
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