Organization
SKIN CENTER OF GEORGIA, PC
Active
Organization
SKIN CENTER OF GEORGIA, PC
Active
Other names
Georgia Skin Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MISTY CAUDELL M.D. (PRESIDENT)
(706) 201-6324
Entity
Organization
Contact information
Practice address
1250 JESSE JEWELL PKWY SE, SUITE 500, GAINESVILLE, GA 30501-3871
(770) 535-7546
(770) 535-7591
Mailing address
PO BOX 1456, GAINESVILLE, GA 30503-1456
(770) 535-7546
(770) 535-7591
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
058402
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101343342
—
PA
Enumeration date
02/12/2016
Last updated
03/10/2016
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