OrganizationActive
Plastic Surgery Center, P.A.
NPI 1063549178 · Plastic and Reconstructive Surgery Physician · Jackson, MS
Provider details
- NPI number
- 1063549178
- Entity type
- Organization
- Primary specialty
- Plastic and Reconstructive Surgery PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Diana Gorman, Vice Pres- Office Manager(601) 373-3730
- License
- 08261 (MS)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
1920 Chadwick Dr
Suite 108
Jackson, MS 39204-3471
Phone: (601) 373-3730
Approximate (ZIP-level) locationGet directions
Mailing address
1920 Chadwick Dr
Jackson, MS 39204-3471
Registry dates
- Enumerated
- 2007-02-27
- Last updated
- 2008-04-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.