Provider Demographics
NPI:1215029053
Name:AUBURN DERMATOLOGY AND SKIN CANCER CENTER
Entity Type:Organization
Organization Name:AUBURN DERMATOLOGY AND SKIN CANCER CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PATTY
Authorized Official - Middle Name:
Authorized Official - Last Name:MAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-887-5060
Mailing Address - Street 1:785 N DEAN RD STE 400
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36830-4034
Mailing Address - Country:US
Mailing Address - Phone:334-887-5060
Mailing Address - Fax:334-887-4367
Practice Address - Street 1:785 N DEAN RD STE 400
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:AL
Practice Address - Zip Code:36830-4034
Practice Address - Country:US
Practice Address - Phone:334-887-5060
Practice Address - Fax:334-887-4367
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-29
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALJ950OtherMEDICARE PROVIDER NUMBER
ALJ950OtherMEDICARE PROVIDER NUMBER
AL=========OtherTAX ID NUMBER