Accent Plastic & Reconstructive Surgery
Organization Active NPI Plastic Surgery Physician · Tupelo, MS
NPI 1215048939 · NPPES record last updated Aug 1, 2011
Key facts
- NPI
- 1215048939
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Plastic Surgery Physician 208200000X
- Legal business name
- ACCENT PLASTIC & RECONSTRUCTIVE SURGERY
- Practice address
- 607 Garfield St
Tupelo, MS 38801-6337 - Phone
- (662) 377-6290
- Fax
- (662) 377-6295
- NPI assigned
- Aug 31, 2006
- Organization subpart
- No
Authorized official
- Name
- Mark Craig
- Title
- MD
- Phone
- (662) 377-6290
Practitioners 1
-
Mark H Craig, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080122000158 | MS | Part B Supplier - Clinic/Group Practice | 4183705759 |
Receives reassigned benefits from 1 practitioner Practice locations: Tupelo, MS |
National Provider Directory
Locations
2147 Southridge Dr
Tupelo, MS 38801
Phone (662) 377-6290
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Plastic Surgery Physician |
208200000X | Yes |
Addresses
Primary practice location
607 Garfield St
Tupelo, MS 38801-6337
Mailing address
607 Garfield St
Tupelo, MS 38801-6337
Phone (662) 377-6290
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00112173 | Medicaid | MS | |
| 512I240008 | Other | MS | MEDICARE PTAN |
| 512G700031 | Other | MS | MEDICARE GROUP |
Other providers in Tupelo, MS
- Ability Prosthetics, LLC
- Mai Mohamed Gaber Abouzeid
- Ralph Sumner Abraham IV
- Lisa Abstein
- Mohammad Jamal Abufadalah
- Access Family Health Services, Inc.
- Amanda Adair
- Pamela Adair
- Becky A Adams
- Jennifer Adams
All providers in Tupelo, MS · Plastic Surgery Physician in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 1, 2011. 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.