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NPI Code Detail

MEDICARE: DERMATOLOGY ASSOCIATES INC. APMC

MEDICARE: DERMATOLOGY ASSOCIATES INC. APMC
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
1207N00000XDermatology Physician024992LA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1891816286
Entity Type Code : Organization
Provider Name (Legal Business Name) : DERMATOLOGY ASSOCIATES INC. APMC
Provider Business Mailing Address
First Line : 324 CIRCLE DRIVE
Second Line :
City : WEST MONROE
State : LA
Zip : 71291-5308
Country : US
Telephone Number : 318-322-3535
Fax Number :
Provider Business Practice Location Address
First Line : 324 CIRCLE DRIVE
Second Line :
City : WEST MONROE
State : LA
Zip : 71291-5308
Country : US
Telephone Number : 318-322-3535
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : VIRGINIA P LEWIS
Credential : M.D.
Telephone Number : 318-322-3535
Provider Enumeration Date : 04/03/2007
Last Update Date : 10/25/2010

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Directions to “DERMATOLOGY ASSOCIATES INC. APMC ” Practice Location

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