Statesboro Plastic Surgery

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

061556 Issued in GA

Legal business name

STATESBORO PLASTIC SURGERY

Practice address

1402 Brampton Ave
Statesboro, GA 30458

Phone

(912) 681-3330

Fax

(912) 681-3303

NPI assigned

Sep 19, 2008

Organization subpart

No

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

Authorized official

Name

Mark E Bisseck, M.D.

Title

Physician/Owner

Phone

(912) 681-3330

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 1

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

• Marc E Bisseck, M.D.

  • Plastic Surgery Physician
  • Statesboro, GA
  • NPI 1841257300
  Medicare reassignment NPD

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

{
    "created_epoch": "1221782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350345600000",
    "number": "1982854568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1402 BRAMPTON AVE",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "30458",
            "telephone_number": "912-681-3330",
            "fax_number": "912-681-3303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1402 BRAMPTON AVE",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "30458",
            "telephone_number": "912-681-3330",
            "fax_number": "912-681-3303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATESBORO PLASTIC SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-19",
        "last_updated": "2012-10-16",
        "status": "A",
        "authorized_official_last_name": "BISSECK",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "912-681-3330",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": "GA",
            "license": "061556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Statesboro Opco LLC
• Statesboro Oral and Maxillofacial Surgery, Inc.
• Statesboro Pathology Associates
• Statesboro Pediatric Dentistry, LLC
• Statesboro Physical Therapy Services Inc
• Statesboro Psychiatric Associates
• Statesboro Trails of Journey LLC
• Statesboro Urologic Clinic, PC
• Stattesboro Orthopaedic Center, Inc
• Sarah Ellen Elza Stephens, M.D.

• Plastic Surgery Physician in Statesboro, GA
• Providers in Statesboro, GA by specialty
• Plastic Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2012; 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.