Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Bespoke Aesthetics and Plastic Surgery

Organization Plastic Surgery Physician · NPI 1417783317

Bespoke Aesthetics and Plastic Surgery is a Plastic Surgery Physician in Madison, Mississippi. Registered with an NPI since 2024.

In the registry since
2024

Practice location Address checks out

161 Montgomery St Ste C
Madison, MS 39110-1119
Phone: (601) 987-6581
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Plastic Surgery Physician (primary) Taxonomy 208200000X

Record details

NPI number1417783317
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Erica Bass — Owner · (601) 987-6581
NPI enumeratedSeptember 9, 2024
Last updated in NPPESOctober 30, 2025
Certification dateOctober 30, 2025
Mailing addressPo Box 1998, Madison, MS 39130-1998

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