Healthcare Provider Details

I. General information

NPI: 1780453464
Provider Name (Legal Business Name): TLK DERMATOLOGY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2023
Last Update Date: 10/29/2025
Certification Date: 10/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

360 SUNSET AVE
ASHEBORO NC
27203-5612
US

IV. Provider business mailing address

360 SUNSET AVE
ASHEBORO NC
27203-5612
US

V. Phone/Fax

Practice location:
  • Phone: 336-625-8410
  • Fax:
Mailing address:
  • Phone: 336-625-8410
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZD0900X
TaxonomyDermatopathology (Pathology) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State

VIII. Authorized Official

Name: JAMES TODD WILLIAMS
Title or Position: OWNER
Credential: MD
Phone: 336-625-8410