DEEP SOUTH DERMATOLOGY NPI 1710054556

NPI Information

  • NPI: 1710054556
  • Provider Name: DEEP SOUTH DERMATOLOGY
  • Classification: Specialist - 174400000X
  • Entity Type: Organization
  • Address: 8573 COUNTY ROAD 64
    DAPHNE, AL
    ZIP 36526
  • Phone: (251) 621-2244

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NPI Details

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:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1174400000XSpecialist00018113ALABAMAYes

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
130930OTHERALABAMAAL BLUE CROSS
2F91474MEDICARE UPINALABAMA
3000030930MEDICARE PIN

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: 11/21/2025

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