Organization
DERMATOLOGY SPECIALISTS OF AUGUSTA, INC
Active
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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