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Organization

RICHARD LEE AVERITTE JR PLLC

Active
Other names
Affiliated Dermatology
Organization subpart
No

Provider details

NPI number
Authorized official
MARLIE AVERITTE (CFO)
(480) 556-0446
Entity
Organization

Contact information

Practice address
19646 N 27TH AVE, STE 305, PHOENIX, AZ 85027-4017
(480) 556-0446
Mailing address
20401 N 73RD ST, STE 230, SCOTTSDALE, AZ 85255-4107
(480) 556-0446

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
40537
AZ
207ND0101X
MOHS-Micrographic Surgery Physician
40537
AZ
207ND0900X
Dermatopathology Physician
40537
AZ
207NI0002X
Clinical & Laboratory Dermatological Immunology Physician
40537
AZ
207NP0225X
Pediatric Dermatology Physician
40537
AZ
207NS0135X
Procedural Dermatology Physician
40537
AZ

Other

Enumeration date
02/25/2014
Last updated
02/25/2014
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