Organization
COMMONWEALTH PLASTIC SURGERY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JARED CHRISTIAN NIMTZ MD (MANAGING PARTNER)
(859) 420-3256
Entity
Organization
Contact information
Practice address
715 SHAKER DR STE 100, LEXINGTON, KY 40504-3674
(859) 277-9435
(859) 277-8852
Mailing address
715 SHAKER DR STE 100, LEXINGTON, KY 40504-3674
(859) 277-9435
(859) 277-8852
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
46515
KY
Other
Enumeration date
04/08/2014
Last updated
10/17/2018
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