Organization
DERMATOLOGY AND SKIN CANCER CLINIC, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WAYNE M. PITRE M.D. (PRESIDENT)
(601) 636-6675
Entity
Organization
Contact information
Practice address
1202 MISSION PARK DR, VICKSBURG, MS 39180-3758
(601) 636-6675
(601) 636-6677
Mailing address
1202 MISSION PARK DR, VICKSBURG, MS 39180-3758
(601) 636-6675
(601) 636-6677
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
01/22/2007
Last updated
11/29/2010
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