Organization
SOUTH FULTON DERMATOLOGY ASSOCIATES,LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK F BAUCOM M.D. (PARTNER)
(404) 763-4153
Entity
Organization
Contact information
Practice address
2719 FELTON DR, EAST POINT, GA 30344-3603
(404) 763-4153
Mailing address
1006 STOVALL BOULEVARD, ATLANTA, GA 30319
(404) 869-4428
Taxonomy
Speciality
Code
Description
License number
State
207NS0135X
Procedural Dermatology Physician
Primary
—
GA
Other
Enumeration date
12/18/2006
Last updated
08/22/2020
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