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

Obsidian Surgical LLC

Organization Plastic Surgery Physician · NPI 1154857548

Obsidian Surgical LLC is a Plastic Surgery Physician in Avon, Indiana. Licensed in Indiana. Registered with an NPI since 2017.

Licensed in
IN
In the registry since
2017
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

10090 E US Highway 36 Ste D
Avon, IN 46123-8175
Phone: (317) 399-4567
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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 · Licence 01068593A (IN)

Record details

NPI number1154857548
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Stanley Harper — Md/President/Owner · (317) 399-4567
NPI enumeratedMay 4, 2017
Last updated in NPPESMay 4, 2017
Mailing address1805 Beaufain St, Carmel, IN 46032-7202

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