Southern Institute of Plastic Surgery, Inc.

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

31063 Issued in AL

Legal business name

SOUTHERN INSTITUTE OF PLASTIC SURGERY, INC.

Practice address

2800 Ross Clark Cir
Suite 2
Dothan, AL 36301-2040

Phone

(334) 699-7477

NPI assigned

Aug 28, 2014

Organization subpart

No

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

Authorized official

Name

Jeffery L Walding, MDNPI 1366629917

Title

Director

Phone

(334) 699-7477

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jeffery L Walding, MD

  • Plastic and Reconstructive Surgery Physician
  • Dothan, AL
  • NPI 1366629917
  Medicare reassignment Care Compare group NPD Authorized official
• Scott Alan Asher, M.D.

  • Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
  • Dothan, AL
  • NPI 1316109978
  Medicare reassignment Care Compare group NPD
• Sydney K Givens, PA

  • Physician Assistant
  • Dothan, AL
  • NPI 1992236889
  Medicare reassignment

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

{
    "created_epoch": "1409184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427846400000",
    "number": "1154721983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 ROSS CLARK CIR",
            "address_2": "SUITE 2",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363012040",
            "telephone_number": "334-699-7477",
            "fax_number": "334-699-7548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 ROSS CLARK CIR",
            "address_2": "SUITE 2",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363012040",
            "telephone_number": "334-699-7477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN INSTITUTE OF PLASTIC SURGERY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-28",
        "last_updated": "2015-04-01",
        "status": "A",
        "authorized_official_last_name": "WALDING",
        "authorized_official_first_name": "JEFFERY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "334-699-7477",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": "AL",
            "license": "31063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Plastic Surgery Physician in Dothan, AL
• Providers in Dothan, AL by specialty
• Plastic Surgery Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.