Organization
GREENVILLE PLASTIC SURGERY, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JACKIE M MCLAWHORN (OFFICE MANAGER)
(252) 758-6627
Entity
Organization
Contact information
Practice address
400 SPRING FOREST RD, GREENVILLE, NC 27834-7244
(252) 758-6627
(252) 830-5168
Mailing address
400 SPRING FOREST RD, GREENVILLE, NC 27834-7244
(252) 758-6627
(252) 830-5168
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0146N
BCBS GROUP ID #
NC
05
—
890146N
—
NC
Enumeration date
04/04/2006
Last updated
09/04/2007
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