Organization
WEST GEORGIA DERMATOLOGY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARIN DANIEL BARTH MD (OWNER)
(706) 882-5119
Entity
Organization
Contact information
Practice address
1605 WHITESVILLE ST, LAGRANGE, GA 30240-5903
(706) 882-5119
(706) 882-0270
Mailing address
1605 WHITESVILLE ST, LAGRANGE, GA 30240-5903
(706) 882-5119
(706) 882-0270
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
30949
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
280767
BC/BS PROVIDER NUMBER
GA
Enumeration date
08/10/2006
Last updated
03/20/2014
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