Blair County Plastic Surgery Inc.
Organization Active NPI Plastic and Reconstructive Surgery Physician · Hollidaysburg, PA
NPI 1013997204 · NPPES record last updated Dec 4, 2024
Key facts
- NPI
- 1013997204
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Plastic and Reconstructive Surgery Physician 2086S0122X
- License
- MD045155E (PA)
- Legal business name
- BLAIR COUNTY PLASTIC SURGERY INC.
- Practice address
- 601 Hawthorne Dr
Suite 100
Hollidaysburg, PA 16648 - Phone
- (814) 949-7280
- Fax
- (814) 949-7283
- NPI assigned
- Jan 23, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. Robert Brian Louton, MD
- Title
- Owner
- Phone
- (814) 949-7280
Corporate family (same tax ID) 1
Practitioners 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20061013000038 | PA | Part B Supplier - Clinic/Group Practice | 7113923236 |
Receives reassigned benefits from 1 practitioner Practice locations: Altoona, PA; Hollidaysburg, PA; State College, PA |
National Provider Directory
- Tax ID family
- Blair Co Plastic Surgery
Locations
1952 Waddle Rd
State College, PA 16803
450 Windmere Dr
State College, PA 16801
1952 Waddle Rd
Ste 102
State College, PA 16803
Phone (814) 234-1420
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Plastic and Reconstructive Surgery Physician |
2086S0122X | MD045155E | PA | Yes |
Addresses
Primary practice location
601 Hawthorne Dr
Suite 100
Hollidaysburg, PA 16648
Mailing address
601 Hawthorne Dr
Suite 100
Hollidaysburg, PA 16648
Phone (814) 949-7280
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 240002639 | Other | PA | MEDICARE PALMETTO |
| 00011873520001 | Medicaid | PA | |
| E83543 | Other | PA | PREFERRED HEALTH CARE |
Other providers in Hollidaysburg, PA
- Jeffrey Lynn Bayliff
- Brad Beatty
- Kimberly Ann Bennett
- Ashley Suzanne Benton
- Gretchen Bettwy
- Blair Foot and Ankle LLC
- Blair Medical Associates
- Blair Medical Associates - Hollidaysburg
- Bradley Peters LPC
- Larry Wayne Breedlove
All providers in Hollidaysburg, PA · Plastic and Reconstructive Surgery Physician in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 4, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.