| NPI | 1720100522 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK FRANCIS BAUCOM President 404-943-1996 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2012-01-05 |