Organization
ADVANCED DERMATOLOGY OF GEORGIA, LLC
Active
Organization
ADVANCED DERMATOLOGY OF GEORGIA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY DECLUE (DIRECTOR OF PROVIDER SERVICES)
(407) 875-2080
Entity
Organization
Contact information
Practice address
401 W 4TH AVE, ALBANY, GA 31701-1915
(229) 883-1130
(229) 883-1153
Mailing address
151 SOUTHHALL LN, SUITE 300, MAITLAND, FL 32751-7176
(407) 875-2080
(407) 650-3455
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Enumeration date
06/16/2015
Last updated
01/22/2018
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