Organization
BESPOKE AESTHETICS AND PLASTIC SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERICA BASS MD (OWNER)
(601) 987-6581
Entity
Organization
Contact information
Practice address
161 MONTGOMERY ST STE C, MADISON, MS 39110-1119
(601) 987-6581
Mailing address
PO BOX 1998, MADISON, MS 39130-1998
(601) 987-6581
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
—
—
Other
Enumeration date
09/09/2024
Last updated
10/30/2025
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