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NPI Code Detail

MEDICARE: HALEY DERMATOLOGY LLC

MEDICARE: HALEY DERMATOLOGY LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1173000000XLegal Medicine

General Provider Information

NPI Number : 1194891150
Entity Type Code : Organization
Provider Name (Legal Business Name) : HALEY DERMATOLOGY LLC
Provider Business Mailing Address
First Line : 202 ROCK CREEK PARKWAY
Second Line :
City : FAIRHOPE
State : AL
Zip : 36532-3349
Country : US
Telephone Number : 251-928-3844
Fax Number : 251-928-3353
Provider Business Practice Location Address
First Line : 202 ROCK CREEK PKWY
Second Line :
City : FAIRHOPE
State : AL
Zip : 36532-3349
Country : US
Telephone Number : 251-928-3844
Fax Number : 251-928-3353
Authorized Official
Title or Position : OWNER PRESIDENT
Name : DR. HEATHER R HALEY
Credential : M.D.
Telephone Number : 251-928-3844
Provider Enumeration Date : 11/28/2006
Last Update Date : 01/13/2012

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Directions to “HALEY DERMATOLOGY LLC ” Practice Location

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