Organization
GENESIS PLASTIC SURGERY AND MEDICAL SPA INC.,P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAYESH PANCHAL MD (PHYSICIAN)
(405) 340-9949
Entity
Organization
Contact information
Practice address
2505 S KELLY AVE, EDMOND, OK 73013
(405) 340-9949
Mailing address
2505 S KELLY AVE, EDMOND, OK 73013-5796
(405) 340-9949
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
20347
OK
Other
Enumeration date
03/04/2008
Last updated
11/29/2011
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