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GULF COAST DERMATOLOGY AND SKIN CARE CENTRE PLLC NPI 1588952857


NPI Information

NPI: 1588952857
Provider Name: GULF COAST DERMATOLOGY AND SKIN CARE CENTRE PLLC
Classification: Dermatology - 207N00000X
Entity Type: Organization

CLIA Number: 01D1011218

Address:
29653 ANCHOR CROSS BLVD
DAPHNE, AL
ZIP 36526
Phone: (251) 631-3570
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GULF COAST DERMATOLOGY AND SKIN CARE CENTRE PLLC is a dermatology in Daphne, AL. The provider is a dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. GULF COAST DERMATOLOGY AND SKIN CARE CENTRE PLLC NPI is 1588952857. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

29653 ANCHOR CROSS BLVD
DAPHNE, AL
ZIP 36526-594
Phone: (251) 631-3570
Fax: (251) 631-3572

The provider's authorized official is Thomas W. Bender .
The authorized official title is Owner and has the following contact phone number (251) 631-3570.

The CLIA number assigned to this NPI record is 01D1011218 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/20/2011 and was last updated on 4/3/2013.


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
1207N00000XDermatology21520ALABAMAYes

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
11750614301MEDICAIDALABAMA
2102G707171MEDICARE PINALABAMA

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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