Provider Demographics
NPI:1689993156
Name:DERMATOLOGY OF NORTH ALABAMA, INC.
Entity Type:Organization
Organization Name:DERMATOLOGY OF NORTH ALABAMA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:B
Authorized Official - Last Name:WHARTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:205-422-1593
Mailing Address - Street 1:2307 HOMER CLAYTON DR
Mailing Address - Street 2:
Mailing Address - City:GUNTERSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35976-2205
Mailing Address - Country:US
Mailing Address - Phone:256-571-8770
Mailing Address - Fax:
Practice Address - Street 1:2307 HOMER CLAYTON DR
Practice Address - Street 2:
Practice Address - City:GUNTERSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35976-2205
Practice Address - Country:US
Practice Address - Phone:205-422-1593
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-24
Last Update Date:2010-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty