Organization
DERMATOLOGY AFFILIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VIRGINIA RUTLEDGE FORNEY MD (DIRECTOR/OFFICER)
(404) 816-7900
Entity
Organization
Contact information
Practice address
3131 MAPLE DR NE, SUITE 102, ATLANTA, GA 30305
(404) 816-7900
(404) 816-7929
Mailing address
PO BOX 52226, ATLANTA, GA 30355-0226
(404) 816-7900
(404) 816-7929
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
044218
GA
Other
Enumeration date
12/27/2006
Last updated
08/29/2018
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