| NPI | 1194124834 |
|---|---|
| Doing Business As | PINE BELT DERMATOLOGY & SKIN CANCER CENTER |
| Entity Type | Organization |
| Authorized Contact | CHARITY ELLINGTON Credentialing Supervisor 601-475-9968 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: MS 21178) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2014-08-19 |
| Last Update Date | 2026-09-28 |