Organization
SHELBY DERMATOLOGY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT LAND HENDERSON JR. M.D. (PRESIDENT)
(205) 621-9500
Entity
Organization
Contact information
Practice address
1022 1ST STREET NORTH, SUITE 201, ALABASTER, AL 35007
(205) 621-9500
Mailing address
1022 1ST STREET NORTH, SUITE 201, ALABASTER, AL 35007
(205) 621-9500
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
00025681
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51532549
BCBS
AL
Enumeration date
10/04/2006
Last updated
08/22/2020
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