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General NPI Number Information
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NPI Number | 1538359617
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Entity Type | Organization
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Legal Business Name | BUCKHEAD DERMATOLOGY
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Dates
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Enumeration Date | 07/26/2007
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Last Update Date | 07/26/2007
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Provider Practice Location Address
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Address Line | 2961 HARDMAN CT NE
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City | ATLANTA
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State | GA
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Zip | 30305-3424
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Country | US
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Telephone | 404-816-4000
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Fax | 404-816-4020
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Provider Business Mailing Address
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Address Line | PO BOX 53136
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City | ATLANTA
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State | GA
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Zip | 30355-1136
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Country | US
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Telephone | 404-816-4000
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Fax | 404-816-4020
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SHERRIE-ANN V STRAUGHN
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Credential | M.D.
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Telephone | 404-816-4000
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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 | 033207
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License Number State | GA
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