| NPI | 1124008636 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOIS W SALLAS Administrator 334-793-9564 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207NS0135X Dermatology, Procedural Dermatology |
| Additional Taxonomies | 207N00000X Dermatology |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery | |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2025-09-11 |