Organization
DERMATOLOGY SPECIALISTS OF GEORGIA, LLC
Active
Organization
DERMATOLOGY SPECIALISTS OF GEORGIA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JON R WARD MD (MD/OWNER)
(850) 233-3376
Entity
Organization
Contact information
Practice address
658 N CHASE STREET UNIT 102, ATHENS, GA 30601
(877) 231-3376
(850) 522-8354
Mailing address
2505 HARRISON AVE, PANAMA CITY, FL 32405-4464
(877) 231-3376
(850) 522-8354
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
18041
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000084961B
—
GA
01
—
10059273
AMERIGROUP
GA
01
—
30926
WELLCARE
GA
Enumeration date
02/05/2007
Last updated
09/02/2022
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up