Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Genesis Plastic Surgery and Medical Spa Inc , PC

Organization Plastic Surgery Physician · NPI 1174793277

Genesis Plastic Surgery and Medical Spa Inc , PC provides Plastic Surgery Physician services in Edmond, Oklahoma. Licensed in Oklahoma. Registered with an NPI since 2008.

Licensed in
OK
In the registry since
2008
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

2505 S Kelly Ave
Edmond, OK 73013 Not confirmed with CMS for 14 years — call before visiting
Phone: (405) 340-9949
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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 20347 (OK)

Record details

NPI number1174793277
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jayesh Panchal — Physician · (405) 340-9949
NPI enumeratedMarch 4, 2008
Last updated in NPPESNovember 29, 2011
Mailing address2505 S Kelly Ave, Edmond, OK 73013-5796

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