Organization
BERKSHIRE PLASTIC SURGEONS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL MICHAEL HAIDAK MD (OWNER)
(931) 841-3311
Entity
Organization
Contact information
Practice address
105 LEDFORD MILL RD, SUITE B, TULLAHOMA, TN 37388-8261
(931) 841-3311
(931) 841-3314
Mailing address
PO BOX 220, TULLAHOMA, TN 37388
(931) 841-3311
(931) 841-3314
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
MD44645
TN
Other
Enumeration date
09/05/2006
Last updated
09/13/2013
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