Organization
DERMATOLOGY AND SKIN SURGERY CLINIC
Active
Organization
DERMATOLOGY AND SKIN SURGERY CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GEORGE B INGRISH MD (PHYSICIAN PRESIDENT)
(318) 449-8600
Entity
Organization
Contact information
Practice address
201 4TH ST, SUITE 4B, ALEXANDRIA, LA 71301-8421
(318) 449-8600
(318) 449-1461
Mailing address
201 4TH ST # 30127, SUITE 4-B, ALEXANDRIA, LA 71301-8421
(318) 449-8600
(318) 449-1461
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CI9696
RAILROAD MEDICARE
LA
Enumeration date
07/26/2006
Last updated
08/10/2010
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