Healthcare Provider Details

I. General information

NPI: 1528737715
Provider Name (Legal Business Name): SPECTRUM DERMATOLOGY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2021
Last Update Date: 02/25/2022
Certification Date: 02/25/2022
Deactivation Date: 12/22/2021
Reactivation Date: 02/25/2022

III. Provider practice location address

2394 N ALMA SCHOOL RD
CHANDLER AZ
85224-2459
US

IV. Provider business mailing address

5141 VIRGINIA WAY STE 350
BRENTWOOD TN
37027-2319
US

V. Phone/Fax

Practice location:
  • Phone: 480-948-8400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number
License Number State

VIII. Authorized Official

Name: PAULA KAYE LAPINSKI
Title or Position: OWNER
Credential: MD
Phone: 815-744-8554