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DAVID B ROY DO PA NPI 1194124834


NPI Information

NPI: 1194124834
Provider Name: DAVID B ROY DO PA

Doing Business As: PINE BELT DERMATOLOGY & SKIN CANCER CENTER

Classification: Dermatology - 207ND0101X
Entity Type: Organization

Specialization: MOHS-Micrographic Surgery

Address:
201 S MAIN ST
PETAL, MS
ZIP 39465
Phone: (318) 884-9706
Get Directions

DAVID B ROY DO PA is a mohs-micrographic surgery dermatology in Petal, MS. The provider is the highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S. DAVID B ROY DO PA NPI is 1194124834. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Pine Belt Dermatology & Skin Cancer Center.

The provider's business location address is:

201 S MAIN ST
PETAL, MS
ZIP 39465-362
Phone: (318) 884-9706

The provider's authorized official is Joy Lynn Moore .
The authorized official title is Office Manager and has the following contact phone number (513) 267-3658.

The enumeration date for this NPI number is 8/19/2014 and was last updated on 1/29/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207ND0101XDermatologyMOHS-Micrographic Surgery21178MISSISSIPPIYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1302I076867MEDICARE PINMISSISSIPPI
21194124834OTHERMISSISSIPPIGROUP NPI
3595626050OTHERMISSISSIPPIBC/BS OF MS
409537875MEDICAIDMISSISSIPPI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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