Organization
MCCORMACK PLASTIC SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIFFANY D MCCORMACK MD (PRESIDIENT)
(775) 284-2020
Entity
Organization
Contact information
Practice address
10791 DOUBLE R BOULEVARD, RENO, NV 89521
(775) 284-2020
(775) 284-2023
Mailing address
10791 DOUBLE R BOULEVARD, RENO, NV 89521
(775) 284-2020
(775) 284-2023
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
12004
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100513000
—
NV
01
—
1083789481
INDIVIDUAL NPI
NV
Enumeration date
07/29/2008
Last updated
05/12/2014
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