Provider Demographics
NPI:1104088558
Name:NEW HORIZONS PLASTIC SURGERY LLC
Entity type:Organization
Organization Name:NEW HORIZONS PLASTIC SURGERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:J
Authorized Official - Last Name:WEBB
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:251-599-8425
Mailing Address - Street 1:1506 N MCKENZIE ST
Mailing Address - Street 2:STE #107
Mailing Address - City:FOLEY
Mailing Address - State:AL
Mailing Address - Zip Code:36535-2261
Mailing Address - Country:US
Mailing Address - Phone:251-219-4175
Mailing Address - Fax:251-517-0339
Practice Address - Street 1:1506 N MCKENZIE ST
Practice Address - Street 2:STE #107
Practice Address - City:FOLEY
Practice Address - State:AL
Practice Address - Zip Code:36535-2261
Practice Address - Country:US
Practice Address - Phone:251-219-4175
Practice Address - Fax:251-517-0339
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-26
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL27164208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALI50215Medicare UPIN