Provider Demographics
NPI:1124378831
Name:TOTAL HEALTH & SKIN CENTER
Entity Type:Organization
Organization Name:TOTAL HEALTH & SKIN CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:BETSY
Authorized Official - Middle Name:
Authorized Official - Last Name:ROOP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-557-6400
Mailing Address - Street 1:108 BASS LAKE RD
Mailing Address - Street 2:
Mailing Address - City:HOLLY SPRINGS
Mailing Address - State:NC
Mailing Address - Zip Code:27540-7620
Mailing Address - Country:US
Mailing Address - Phone:919-557-6400
Mailing Address - Fax:919-557-6410
Practice Address - Street 1:108 BASS LAKE RD
Practice Address - Street 2:
Practice Address - City:HOLLY SPRINGS
Practice Address - State:NC
Practice Address - Zip Code:27540-7620
Practice Address - Country:US
Practice Address - Phone:919-557-6400
Practice Address - Fax:919-557-6410
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-11
Last Update Date:2018-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC35603208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty