| NPI | 1205518875 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN MELVIN SQUIRES CEO And President 706-432-9285 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery |
| Enumeration Date | 2023-08-03 |
| Last Update Date | 2023-08-03 |