NPI 1174793277

Genesis Plastic Surgery and Medical Spa Inc.,p.C.

Organisation Plastic Surgery Physician Edmond, OK

Practice location

Address: 2505 S Kelly Ave, Edmond, OK 73013
Phone: (405) 340-9949
Mailing address: 2505 S Kelly Ave, Edmond, OK 73013-5796

Authorised official

Name: Jayesh Panchal
Title: Physician
Phone: (405) 340-9949

Registered specialties

Plastic Surgery Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208200000X Licence 20347 (OK)

Other Plastic Surgery providers in Oklahoma →

Registry record

NPI: 1174793277
Entity type: Organization
NPI issued: 4 Mar 2008
Record last updated: 29 Nov 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.