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

Plastic Surgery Center, PA

Organization Plastic and Reconstructive Surgery Physician · NPI 1063549178

Plastic Surgery Center, PA is a Plastic and Reconstructive Surgery Physician in Jackson, Mississippi. Licensed in Mississippi. Registered with an NPI since 2007.

Licensed in
MS
In the registry since
2007
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1920 Chadwick Dr Ste 108
Jackson, MS 39204-3471
Phone: (601) 373-3730
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Plastic and Reconstructive Surgery Physician (primary) Taxonomy 2086S0122X · Licence 08261 (MS)

Record details

NPI number1063549178
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Diana Gorman — Vice Pres- Office Manager · (601) 373-3730
NPI enumeratedFebruary 27, 2007
Last updated in NPPESApril 20, 2008
Mailing address1920 Chadwick Dr, Suite 108, Jackson, MS 39204-3471

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