Healthcare Provider Details

I. General information

NPI: 1851421531
Provider Name (Legal Business Name): DERMATOLOGY CONSULTANTS, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2007
Last Update Date: 07/14/2022
Certification Date: 07/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3280 HOWELL MILL RD NW STE 211
ATLANTA GA
30327-4100
US

IV. Provider business mailing address

3280 HOWELL MILL RD NW STE 211
ATLANTA GA
30327-4100
US

V. Phone/Fax

Practice location:
  • Phone: 404-351-7546
  • Fax: 404-352-4706
Mailing address:
  • Phone: 404-351-7546
  • Fax: 404-352-4706

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name: MS. KIM HARPER
Title or Position: OFFICE MANAGER
Credential:
Phone: 404-351-7546