Basic Information
| Provider Information | |||||||||
| NPI: | 1114022647 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | WINSLOW FACIAL PLASTIC SURGERY, LLC | ||||||||
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| Address1: | PO BOX 68952 | ||||||||
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| City: | INDIANAPOLIS | ||||||||
| State: | IN | ||||||||
| PostalCode: | 462680952 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3178706702 | ||||||||
| FaxNumber: | 3178700499 | ||||||||
| Practice Location | |||||||||
| Address1: | 2000 E 116TH ST | ||||||||
| Address2: | STE 200 | ||||||||
| City: | CARMEL | ||||||||
| State: | IN | ||||||||
| PostalCode: | 460323508 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3175740974 | ||||||||
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| ProviderEnumerationDate: | 09/13/2006 | ||||||||
| LastUpdateDate: | 07/01/2009 | ||||||||
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| AuthorizedOfficialLastName: | WINSLOW | ||||||||
| AuthorizedOfficialFirstName: | CATHERINE | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 3175740974 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208200000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Plastic Surgery |
No ID Information.