Organization
DERMPATH AND DERM CONSULTANTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KATHLEEN J SMITH MD (OWNER)
(404) 291-0379
Entity
Organization
Contact information
Practice address
1428 SCOTT BLVD, DECATUR, GA 30030-1424
(678) 904-4932
(404) 370-0428
Mailing address
1428 SCOTT BLVD, DECATUR, GA 30030-1424
(678) 904-4932
(404) 370-0428
Taxonomy
Speciality
Code
Description
License number
State
207ND0900X
Dermatopathology Physician
053035
GA
291U00000X
Clinical Medical Laboratory
Primary
27516
SC
Other
Enumeration date
07/19/2013
Last updated
06/13/2014
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