DEEP SOUTH DERMATOLOGY NPI 1710054556

NPI Information

DEEP SOUTH DERMATOLOGY is a specialist in Daphne, AL. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. DEEP SOUTH DERMATOLOGY NPI is 1710054556. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

8573 COUNTY ROAD 64
DAPHNE, AL
ZIP 36526-706
Phone: (251) 621-2244
Fax: (251) 621-7209

The provider's authorized official is Alan R Stanford .
The authorized official title is Owner and has the following contact phone number (251) 621-2244.

The enumeration date for this NPI number is 11/29/2006 and was last updated on 6/3/2008.

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:

Other Identifiers

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

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