Organization
ADVANCED DERMATOLOGIC SURGERY, P.A.
Active
Other names
Advanced Dermatologic Surgery, Trinity Dermatology
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GREG ALBERS MPA (CFO)
(913) 661-1755
Entity
Organization
Contact information
Practice address
6901 W 121ST ST, OVERLAND PARK, KS 66209-2007
(913) 661-1755
(913) 661-9260
Mailing address
6901 W 121ST ST, OVERLAND PARK, KS 66209-2007
(913) 661-1755
(913) 661-9260
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
04-25136
KS
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
—
—
291U00000X
Clinical Medical Laboratory
04-25136
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17D0890923
CLIA #
—
Enumeration date
07/24/2007
Last updated
06/03/2022
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