MEDICARE: DERMATOLOGY AND SKINCARE, PC

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
1	207N00000X	Dermatology Physician	54013	GA

General Provider Information

NPI Number	:	1255402939
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DERMATOLOGY AND SKINCARE, PC

Provider Business Mailing Address
First Line	:	2700 DOUBLE CHURCHES RD
Second Line	:	129
City	:	COLUMBUS
State	:	GA
Zip	:	31909-2786
Country	:	US
Telephone Number	:	706-327-0717
Fax Number	:	706-649-4001

Provider Business Practice Location Address
First Line	:	2320 DOUBLE CHURCHES RD.
Second Line	:	SUITE B
City	:	COLUMBUS
State	:	GA
Zip	:	31909
Country	:	US
Telephone Number	:	706-649-4000
Fax Number	:	706-649-4001

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JAMES GARRIS MORGAN
Credential	:	M.D.
Telephone Number	:	706-649-4000

Provider Enumeration Date	:	11/13/2006
Last Update Date	:	08/22/2020

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