NPIMap

Organization Active NPI

Imc Otolaryngology Facial Plastic & Reconstructive Surgery, P.C.

  • Facial Plastic Surgery Physician
  • Mobile, AL
National Provider Identifier
1275828659
Registry record updated Jun 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Facial Plastic Surgery PhysicianTaxonomy code 207YS0123X
Legal business name
IMC OTOLARYNGOLOGY FACIAL PLASTIC & RECONSTRUCTIVE SURGERY, P.C.
Practice address
3401 Medical Park Dr
BLDG 1, Suite 103
Mobile, AL 36693-3318
Phone
(251) 463-2010
NPI assigned
Jun 14, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2011

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

Authorized official

Name
Mrs. Marianne F Smith
Title
Director
Phone
(251) 463-2010

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Facial Plastic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207YS0123X Primary

Addresses

Primary practice location

3401 Medical Park Dr
BLDG 1, Suite 103
Mobile, AL 36693-3318

Mailing address

3401 Medical Park Dr
BLDG 1, Suite 103
Mobile, AL 36693-3318
Phone (251) 463-2010

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1308009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308009600000",
    "number": "1275828659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 MEDICAL PARK DR",
            "address_2": "BLDG 1, SUITE 103",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366933318",
            "telephone_number": "251-463-2010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 MEDICAL PARK DR",
            "address_2": "BLDG 1, SUITE 103",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366933318",
            "telephone_number": "251-463-2010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMC OTOLARYNGOLOGY FACIAL PLASTIC & RECONSTRUCTIVE SURGERY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-14",
        "last_updated": "2011-06-14",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "MARIANNE",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "251-463-2010",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207YS0123X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2011; 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.