Provider Demographics
NPI:1255402939
Name:DERMATOLOGY AND SKINCARE, PC
Entity type:Organization
Organization Name:DERMATOLOGY AND SKINCARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:GARRIS
Authorized Official - Last Name:MORGAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:706-649-4000
Mailing Address - Street 1:2700 DOUBLE CHURCHES RD
Mailing Address - Street 2:129
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31909-2786
Mailing Address - Country:US
Mailing Address - Phone:706-327-0717
Mailing Address - Fax:706-649-4001
Practice Address - Street 1:2320 DOUBLE CHURCHES RD.
Practice Address - Street 2:SUITE B
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31909
Practice Address - Country:US
Practice Address - Phone:706-649-4000
Practice Address - Fax:706-649-4001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA54013207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty