Provider Demographics
NPI:1588929673
Name:KAYAN PLASTIC SURGERY LLC
Entity type:Organization
Organization Name:KAYAN PLASTIC SURGERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:
Authorized Official - Last Name:KAYAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:612-756-8008
Mailing Address - Street 1:15450 HIGHWAY 7 STE 225
Mailing Address - Street 2:
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55345-3522
Mailing Address - Country:US
Mailing Address - Phone:612-756-8008
Mailing Address - Fax:651-925-0597
Practice Address - Street 1:15450 HIGHWAY 7 STE 225
Practice Address - Street 2:
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55345-3522
Practice Address - Country:US
Practice Address - Phone:612-756-8008
Practice Address - Fax:651-925-0597
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-05
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty