NPIMap

Organization Active NPI

The Clinic of Plastic Surgery, P.a.

  • Plastic Surgery Physician
  • Jackson, MS
National Provider Identifier
1083798029
Registry record updated Jan 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
5413 Issued in MS
Legal business name
THE CLINIC OF PLASTIC SURGERY, P.A.
Practice address
1421 North State St
Suite 504
Jackson, MS 39202
Phone
(601) 969-9050
Fax
(601) 354-2443
NPI assigned
Oct 25, 2006
Last updated
Jan 6, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. William O Thompson, MDNPI 1235164021
Title
President
Phone
(601) 969-9050

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X 5413 MS Primary

Addresses

Primary practice location

1421 North State St
Suite 504
Jackson, MS 39202

Mailing address

1421 North State St
Suite 504
Jackson, MS 39202
Phone (601) 969-9056

Other names 1

  • The Clinic of Plastic Surgery Other name

National Provider Directory

National Provider Directory

Locations

1421 N State St
Ste 504
Jackson, MS 39202
Phone (601) 969-9050

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1546732800000",
    "number": "1083798029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1421 NORTH STATE ST",
            "address_2": "SUITE 504",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "39202",
            "telephone_number": "601-969-9056",
            "fax_number": "601-354-2443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1421 NORTH STATE ST",
            "address_2": "SUITE 504",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "39202",
            "telephone_number": "601-969-9050",
            "fax_number": "601-354-2443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE CLINIC OF PLASTIC SURGERY, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2019-01-06",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "601-969-9050",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "MS",
            "license": "5413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Clinic of Plastic Surgery",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "The Clinic of Plastic Surgery",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Jackson, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.