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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