Organization
HUNTSVILLE PLASTIC SURGERY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICK WILSON MD (PRESIDENT)
(256) 701-1991
Entity
Organization
Contact information
Practice address
2620 CARL T. JONES DR. SE., HUNTSVILLE, AL 35802-4951
(256) 551-2002
(256) 551-2003
Mailing address
805 MADISON STREET, SUITE 1D, HUNTSVILLE, AL 35801-4424
(256) 551-2002
(256) 551-2003
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
—
—
2082S0099X
Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
—
—
2086S0122X
Plastic and Reconstructive Surgery Physician
—
—
Other
Enumeration date
07/27/2022
Last updated
07/27/2022
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