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General NPI Number Information
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NPI Number | 1164605150
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Entity Type | Organization
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Legal Business Name | GEORGIA SKIN SPECIALISTS
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Dates
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Enumeration Date | 12/12/2007
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Last Update Date | 02/07/2012
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Provider Practice Location Address
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Address Line | 1800 HOWELL MILL RD NW SUITE 680
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City | ATLANTA
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State | GA
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Zip | 30318-2538
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Country | US
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Telephone | 404-352-1730
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Fax | 404-352-6907
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Provider Business Mailing Address
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Address Line | 1800 HOWELL MILL RD NW SUITE 680
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City | ATLANTA
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State | GA
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Zip | 30318-2538
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Country | US
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Telephone | 404-352-1730
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Fax | 404-352-6907
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Authorized Official
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Title or Position | OWNER
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Name | LINDA M BENEDICT
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Credential | MD
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Telephone | 404-352-1730
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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