Ophthalmic Plastic and Reconstructive Surgery, P.a.

NPI #1386716157 in Minneapolis, Minnesota

Provider Information

NPI Number: 1386716157
Entity Type: Organization
Organization Name: Ophthalmic Plastic and Reconstructive Surgery, P.a.
Primary Specialty: Specialist
Enumeration Date: Nov 15, 2006
Last Updated: Apr 27, 2010

Practice Location

Address: 4887 E LAKE HARRIET BLVD
City: Minneapolis
State: Minnesota
ZIP Code: 55419-5222
Phone: (612) 325-0317

Authorized Official

Name: DR. RICHARD P CARROLL, M.D.
Title: PRESIDENT/OWNER
Phone: (612) 325-0317

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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