| NPI | 1467696021 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK M HATFIELD Owner 870-698-9100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ND0101X Dermatology MOHS-Micrographic Surgery (Licence: AR E0184) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: AR E0184) |
| 207ND0900X Dermatology Dermatopathology (Licence: AR E0184) | |
| Enumeration Date | 2009-04-27 |
| Last Update Date | 2019-10-09 |