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General NPI Number Information
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NPI Number | 1285245423
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Entity Type | Organization
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Legal Business Name | DERMATOLOGY & SKIN CANCER CENTER PLLC
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Dates
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Enumeration Date | 08/12/2020
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Last Update Date | 01/29/2026
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Provider Practice Location Address
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Address Line | 4612 29TH AVE
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City | MERIDIAN
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State | MS
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Zip | 39305-1652
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Country | US
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Telephone | 601-512-0431
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Fax | 601-482-5065
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Provider Business Mailing Address
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Address Line | PO BOX 649103
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City | DALLAS
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State | TX
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Zip | 75264-9103
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Country | US
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Telephone | 601-512-0431
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Fax | 601-482-5065
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Authorized Official
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Title or Position | OWNER
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Name | EMILY K MATTHEWS
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Credential | DO
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Telephone | 601-512-0431
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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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