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Organization

DECATUR DERMATOLOGY, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SAMANTHA WYATT MD (PHYSICIAN/PRESIDENT)
(256) 353-7775
Entity
Organization

Contact information

Practice address
620 WALNUT STREET NE, SUITE A, DECATUR, AL 35601-2456
(256) 353-7775
(256) 353-7765
Mailing address
620 WALNUT STREET NE, SUITE A, DECATUR, AL 35601-2456
(256) 353-7775
(256) 353-7765

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
207NS0135X
Procedural Dermatology Physician

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
529924440
AL
Enumeration date
07/17/2007
Last updated
08/21/2025
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