Provider Demographics
NPI:1215960307
Name:WOMENS PLASTIC SURGERY & REJUVINATION CENTERE, INC
Entity type:Organization
Organization Name:WOMENS PLASTIC SURGERY & REJUVINATION CENTERE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:BUTTERFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:513-891-5610
Mailing Address - Street 1:4750 E GALBRAITH RD
Mailing Address - Street 2:STE 215
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45236-6705
Mailing Address - Country:US
Mailing Address - Phone:513-891-5610
Mailing Address - Fax:513-891-5638
Practice Address - Street 1:4750 E GALBRAITH RD
Practice Address - Street 2:STE 215
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-6705
Practice Address - Country:US
Practice Address - Phone:513-891-5610
Practice Address - Fax:513-891-5638
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-09
Last Update Date:2014-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2572176Medicaid
OH2572176Medicaid