Healthcare Provider Details

I. General information

NPI: 1699139915
Provider Name (Legal Business Name): CUTANEOUS ONCOLOGY & SURGERY CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2016
Last Update Date: 03/04/2020
Certification Date: 03/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1940 STONEGATE DR STE 140
VESTAVIA HLS AL
35242-2541
US

IV. Provider business mailing address

1940 STONEGATE DR STE 140
VESTAVIA HLS AL
35242-2541
US

V. Phone/Fax

Practice location:
  • Phone: 205-968-3919
  • Fax: 205-968-3918
Mailing address:
  • Phone: 205-968-3919
  • Fax: 205-968-3918

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number StateAL

VIII. Authorized Official

Name: DR. CHRISTOPHER HARMON
Title or Position: OWNER
Credential: MD
Phone: 205-977-9876