Provider Demographics
NPI:1649205774
Name:DERMATOLOGY CONSULTANTS, INC.
Entity Type:Organization
Organization Name:DERMATOLOGY CONSULTANTS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JANE
Authorized Official - Middle Name:B
Authorized Official - Last Name:SOWERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-847-6132
Mailing Address - Street 1:1330 OAK LN
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24503-2513
Mailing Address - Country:US
Mailing Address - Phone:434-847-6132
Mailing Address - Fax:434-845-4870
Practice Address - Street 1:1330 OAK LN
Practice Address - Street 2:SUITE 101
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24503-2513
Practice Address - Country:US
Practice Address - Phone:434-847-6132
Practice Address - Fax:434-845-4870
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CK2505Medicare ID - Type UnspecifiedMEDICARE RAILROAD
C03620Medicare ID - Type Unspecified