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General NPI Number Information
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NPI Number | 1235065590
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Entity Type | Organization
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Legal Business Name | WEST GEORGIA DERM SURGERY CENTER
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Dates
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Enumeration Date | 06/23/2026
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Last Update Date | 06/23/2026
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Provider Practice Location Address
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Address Line | 601 DIXIE ST
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City | CARROLLTON
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State | GA
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Zip | 30117-3816
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Country | US
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Telephone | 770-838-9333
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Fax | 770-838-7755
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Provider Business Mailing Address
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Address Line | 601 DIXIE ST
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City | CARROLLTON
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State | GA
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Zip | 30117-3816
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Country | US
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Telephone | 770-838-9333
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Fax | 770-838-7755
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Authorized Official
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Title or Position | MANAGING DIRECTOR
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Name | SARAH WILSON
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Credential | MD
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Telephone | 770-838-9333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ND0101X
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Taxonomy Name | MOHS-Micrographic Surgery Physician
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License Number |
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License Number State |
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