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Organization

DERMATOLOGY ASSOCIATES OF BAY COUNTY

Active
Parent organization
DERMATOLOGY ASSOCIATES OF BAY COUNTY
Other names
Pathology Services of America Division of Dermatology Associates of Ba
Organization subpart
Yes

Provider details

NPI number
Legal business name
DERMATOLOGY ASSOCIATES OF BAY COUNTY
Authorized official
MR. KENNETH WARREN ALEXANDER HTL(ASCP) (LABORATORY MANAGER)
(850) 215-0953
Entity
Organization

Contact information

Practice address
2430 LISENBY AVE, PANAMA CITY, FL 32405
(850) 215-0953
(850) 215-0952
Mailing address
2430 LISENBY AVE, PANAMA CITY, FL 32405-3585
(850) 215-0953
(850) 215-0952

Taxonomy

Speciality
Code
Description
License number
State
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
800025570
FL

Other

Enumeration date
11/02/2009
Last updated
11/09/2009
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