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Organization

DERMATOLOGY SPECIALISTS OF AUGUSTA, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LISA BROOKS (CREDENTIALING MANAGER)
(727) 547-0607
Entity
Organization

Contact information

Practice address
1203 TOWN PARK LN, EVANS, GA 30809-3481
(706) 650-7546
(706) 922-9169
Mailing address
1306 CONCOURSE DR STE 201, LINTHICUM HEIGHTS, MD 21090-1033
(813) 341-3259
(813) 341-3259

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
207ND0101X
MOHS-Micrographic Surgery Physician
049686
GA
207ND0101X
MOHS-Micrographic Surgery Physician
207NS0135X
Procedural Dermatology Physician

Other

Enumeration date
03/09/2006
Last updated
01/13/2023
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