Organization
COASTAL DERMATOLOGY
Active
Organization
COASTAL DERMATOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY HODGES (BILLING REPRESENTATIVE)
(912) 562-7092
Entity
Organization
Contact information
Practice address
400 COMMERCIAL CT, SAVANNAH, GA 31406-3648
(912) 352-3535
(912) 352-3485
Mailing address
400 COMMERCIAL CT, SAVANNAH, GA 31406-3648
(912) 352-3535
(912) 352-3485
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DF6062
RAILROAD MEDICARE
GA
Enumeration date
05/10/2007
Last updated
09/22/2015
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