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GEORGIA DERMATOLOGIC SURGERY CENTER PC NPI 1720100522


NPI Information

NPI: 1720100522
Provider Name: GEORGIA DERMATOLOGIC SURGERY CENTER, PC
Classification: Dermatology - 207ND0101X
Entity Type: Organization

Specialization: MOHS-Micrographic Surgery

Address:
5555 PEACHTREE DUNWOODY RD NE
SUITE G65
ATLANTA, GA
ZIP 30342
Phone: (404) 943-1996
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GEORGIA DERMATOLOGIC SURGERY CENTER, PC is a mohs-micrographic surgery dermatology in Atlanta, GA. 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. GEORGIA DERMATOLOGIC SURGERY CENTER, PC NPI is 1720100522. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

5555 PEACHTREE DUNWOODY RD NE
SUITE G65
ATLANTA, GA
ZIP 30342-703
Phone: (404) 943-1996
Fax: (404) 943-9464

The provider's authorized official is Mark Francis Baucom .
The authorized official title is President and has the following contact phone number (404) 943-1996.

The enumeration date for this NPI number is 4/4/2007 and was last updated on 1/5/2012.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207ND0101XDermatologyMOHS-Micrographic SurgeryYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1GRP3989MEDICARE ID-TYPE UNSPECIFIEDGEORGIAGROUP NUMBER FOR MEDICARE

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: 4/28/2024

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