Plastic & Reconstructive Surgery of Sumter, PA

Primary specialty

SpecialistTaxonomy code 174400000X

License

17109 Issued in SC

Legal business name

PLASTIC & RECONSTRUCTIVE SURGERY OF SUMTER, PA

Practice address

18 Miller Rd
Sumter, SC 29150-2403

Phone

(803) 773-6361

Fax

(803) 773-6009

NPI assigned

Oct 17, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Gary R. Culbertson, M.D.

Title

President

Phone

(803) 773-6361

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1192579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1417564800000",
    "number": "1659560407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 MILLER RD",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291502403",
            "telephone_number": "803-773-6361",
            "fax_number": "803-773-6009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 MILLER RD",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291502403",
            "telephone_number": "803-773-6361",
            "fax_number": "803-773-6009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLASTIC & RECONSTRUCTIVE SURGERY OF SUMTER, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-17",
        "last_updated": "2014-12-03",
        "status": "A",
        "authorized_official_last_name": "CULBERTSON",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "803-773-6361",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "SC",
            "license": "17109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pinewood Opco LLC
• Omar Adolio Pinilla, M.D,
• Vijay Paul Pinto, M.D.
• Mickelle O'Nea Pitt
• Yvonne Pittman
• Play Therapy of Sumter
• Lisbeth W Poag, DMD
• Brianna Polson
• Eric Laron Portee, LPC-A, ADC-IP, NCC
• Racheal Denise Posey, NP

• Specialist in Sumter, SC
• Providers in Sumter, SC by specialty
• Specialist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2014; 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.