| Lincoln Aesthetic & Reconstructive Surgery Pc | |
|
2222 S 16th St Ste 300 Lincoln NE 68502-3785 | |
| (402) 435-0044 | |
| Not Available |
| Full Name | Lincoln Aesthetic & Reconstructive Surgery Pc |
|---|---|
| Speciality | Plastic Surgery |
| Location | 2222 S 16th St Ste 300, Lincoln, Nebraska |
| Authorized Official Name and Position | Mitchell Henry (PRESIDENT/OWNER) |
| Authorized Official Contact | 4024350044 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lincoln Aesthetic & Reconstructive Surgery Pc 2222 S 16th St Ste 300 Lincoln NE 68502-3785 Ph: (402) 435-0044 | Lincoln Aesthetic & Reconstructive Surgery Pc 2222 S 16th St Ste 300 Lincoln NE 68502-3785 Ph: (402) 435-0044 |
| NPI Number | 1356772420 |
|---|---|
| Provider Enumeration Date | 11/27/2013 |
| Last Update Date | 11/27/2013 |
| Medicare PECOS PAC ID | 4183852544 |
|---|---|
| Medicare Enrollment ID | O20140109000668 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356772420 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 5504 (Nebraska) | Secondary |
| 208200000X | Plastic Surgery | 18887 (Nebraska) | Primary |
| Provider Name | Mitchell J Henry |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1215927181 PECOS PAC ID: 5799753430 Enrollment ID: I20040921000688 |
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