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General NPI Number Information
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NPI Number | 1376970236
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Entity Type | Organization
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Legal Business Name | SKIN PATHOLOGY ASSOCIATES, LLC
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Dates
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Enumeration Date | 10/08/2013
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Last Update Date | 10/08/2013
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Provider Practice Location Address
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Address Line | 3550 INDEPENDENCE DR
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City | BIRMINGHAM
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State | AL
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Zip | 35209-5710
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Country | US
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Telephone | 205-949-2806
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Fax | 205-949-2810
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Provider Business Mailing Address
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Address Line | 3560 INDEPENDENCE DR SUITE 200
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City | BIRMINGHAM
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State | AL
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Zip | 35209-5703
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Country | US
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Telephone | 205-949-2806
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Fax | 205-949-2810
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Authorized Official
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Title or Position | CREDENTIALING
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Name | STEPHANIE HIGGINS
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Credential |
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Telephone | 205-949-2834
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZD0900X
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Taxonomy Name | Dermatopathology (Pathology) Physician
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License Number | L37107
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License Number State | AL
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