Eastern Ky Center for Plastic, Reconstructive & Cosmetic Surgery

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

Legal business name

EASTERN KY CENTER FOR PLASTIC, RECONSTRUCTIVE & COSMETIC SURGERY

Doing business as

Kentucky Center for Plastic Surgery

Practice address

126 Trivette Dr
Suite 201
Pikeville, KY 41501-1275

Phone

(606) 432-0061

Fax

(606) 432-0095

NPI assigned

Apr 23, 2008

Last updated

Jul 15, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Mary Lyn T. Lu, M.D.

Title

President

Phone

(606) 432-0061

Specialties & licenses 1

Addresses

Other identifiers 5

Other names 1

• Kentucky Center for Plastic Surgery Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mary Lyn T Lu, MD, FACS

  • Plastic and Reconstructive Surgery Physician
  • Pikeville, KY
  • NPI 1407844566
  NPD (past)

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

{
    "created_epoch": "1208908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279152000000",
    "number": "1982879888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2257",
            "city": "PIKEVILLE",
            "state": "KY",
            "postal_code": "415022257",
            "telephone_number": "606-432-0061",
            "fax_number": "606-432-0095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 TRIVETTE DR",
            "address_2": "SUITE 201",
            "city": "PIKEVILLE",
            "state": "KY",
            "postal_code": "415011275",
            "telephone_number": "606-432-0061",
            "fax_number": "606-432-0095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN KY CENTER FOR PLASTIC, RECONSTRUCTIVE & COSMETIC SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-23",
        "last_updated": "2010-07-15",
        "status": "A",
        "authorized_official_last_name": "LU",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "LYN T.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "606-432-0061",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WV MEDICAID",
            "identifier": "0114191000",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64256423",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UMWA",
            "identifier": "1532903",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "000000051790",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "R/R MEDICARE",
            "identifier": "240005992",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kentucky Center for Plastic Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jaden Keleigh Easterling, RBT
• Eastern Kentucky Emergency Physicians, LLC
• Eastern Kentucky Kidney Care, PSC
• Eastern Kentucky Treatment
• Eastern Ky Bone & Joint Surgery, PSC
• Eastern Ky. Bone & Joint Surgery,PSC
• Economy Drug Company Inc
• Economy Drug Company Inc
• Robert Edmonds, PHARMD
• Tanya Edmonds, LPN

• Medical Specialty Clinic/Center in Pikeville, KY
• Providers in Pikeville, KY by specialty
• Medical Specialty Clinic/Center in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2010; 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.