Organization
SKIN DIAGNOSTICS GROUP PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES ALAN LONG MD (PRESIDENT)
(205) 879-2260
Entity
Organization
Contact information
Practice address
3512 OLD MONTGOMERY HWY, BIRMINGHAM, AL 35209-5706
(205) 879-2260
(205) 879-2261
Mailing address
3512 OLD MONTGOMERY HWY, BIRMINGHAM, AL 35209-5706
(205) 879-2260
(205) 879-2261
Taxonomy
Speciality
Code
Description
License number
State
207ZD0900X
Dermatopathology (Pathology) Physician
Primary
25042
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25042
MEDICAL LICENSE
AL
Enumeration date
09/08/2009
Last updated
07/27/2015
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