Organization
THE PLASTIC SURGERY CLINIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH ALLEN FISCHER M.D. (OWNER/DOCTOR)
(785) 776-7500
Entity
Organization
Contact information
Practice address
1419 WESTPORT LANDING PL, SUITE 101, MANHATTAN, KS 66502-2906
(785) 776-7500
(785) 770-8558
Mailing address
1419 WESTPORT LANDING PL, SUITE 101, MANHATTAN, KS 66502-2906
(785) 776-7500
(785) 770-8558
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
04-28013
KS
2086S0105X
Surgery of the Hand (Surgery) Physician
04-23013
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100396860A
—
KS
01
—
110967
MEDICARE
KS
Enumeration date
09/19/2007
Last updated
10/30/2012
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