Pacific Plastic Surgery PC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

MD13772 Issued in OR

Legal business name

PACIFIC PLASTIC SURGERY PC

Practice address

743 Country Club Rd
Eugene, OR 97401-6019

Phone

(541) 683-0878

Fax

(541) 683-5206

NPI assigned

Mar 27, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Lois M Fondren, MBA

Title

Manager

Phone

(541) 683-0878

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1143417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1255910400000",
    "number": "1659331007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "743 COUNTRY CLUB RD",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974016019",
            "telephone_number": "541-683-0878",
            "fax_number": "541-683-5206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "743 COUNTRY CLUB RD",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974016019",
            "telephone_number": "541-683-0878",
            "fax_number": "541-683-5206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC PLASTIC SURGERY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-27",
        "last_updated": "2009-10-19",
        "status": "A",
        "authorized_official_last_name": "FONDREN",
        "authorized_official_first_name": "LOIS",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "541-683-0878",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "OR",
            "license": "MD13772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pacific Footwear Company, Inc.
• Pacific Medical, Inc.
• Pacific Natural Medicine, LLC
• Pacific Northwest Wellness LLC
• Pacific NW Mindful Change LLC
• Pacific Sky Counseling
• Pacific Sports and Interventional Spine, LLC-P
• Pacific Surgery Center LLC
• Pacific Womens Center LLC
• Janet B Packer, CADC-R, QMHA-R

• Ambulatory Surgical Clinic/Center in Eugene, OR
• Providers in Eugene, OR by specialty
• Ambulatory Surgical Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2009; 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.