WEST GEORGIA DERMATOLOGY PC NPI 1760493167

NPI Information

NPI: 1760493167
Provider Name: WEST GEORGIA DERMATOLOGY PC
Classification: Specialist - 174400000X
Entity Type: Organization
Address:
1605 WHITESVILLE ST
LAGRANGE, GA
ZIP 30240
Phone: (706) 882-5119
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WEST GEORGIA DERMATOLOGY PC is a specialist in Lagrange, GA. 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. WEST GEORGIA DERMATOLOGY PC NPI is 1760493167. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1605 WHITESVILLE ST
LAGRANGE, GA
ZIP 30240-903
Phone: (706) 882-5119
Fax: (706) 882-0270

The provider's authorized official is Garin Daniel Barth .
The authorized official title is Owner and has the following contact phone number (706) 882-5119.

The enumeration date for this NPI number is 8/10/2006 and was last updated on 3/20/2014.

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
1	174400000X	Specialist		30949	GEORGIA	Yes

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
1	280767	OTHER	GEORGIA	BC/BS PROVIDER NUMBER
2	1760493167	MEDICARE PIN	GEORGIA

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

NPI Synchronization or Removal

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