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General NPI Number Information
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NPI Number | 1194514463
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Entity Type | Organization
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Legal Business Name | THE BEAUTY MARK. BY MD., LLC
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Dates
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Enumeration Date | 05/03/2025
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Last Update Date | 05/03/2025
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Provider Practice Location Address
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Address Line | 619 DELMAS AVE
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City | PASCAGOULA
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State | MS
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Zip | 39567-4226
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Country | US
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Telephone | 228-202-1847
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Fax |
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Provider Business Mailing Address
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Address Line | 619 DELMAS AVE
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City | PASCAGOULA
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State | MS
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Zip | 39567-4226
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Country | US
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Telephone | 228-202-1847
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MAGGIE E DUKE
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Credential | NP
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Telephone | 228-202-1847
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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