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Organization

ADVANCED PLASTIC RECONSTRUCTION PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
PABLO A PRICHARD MD (OWNER)
(602) 331-7811
Entity
Organization

Contact information

Practice address
9250 N 3RD ST, SUITE 1003, PHOENIX, AZ 85020-2402
(602) 331-7811
(602) 331-5886
Mailing address
PO BOX 47490, PHOENIX, AZ 85068-7490
(602) 331-7811
(602) 331-5886

Taxonomy

Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
358484
AZ
01
Z124156
MEDICARE PTAN
Enumeration date
06/23/2008
Last updated
02/27/2018
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