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Organization

DERMATOLOGY ASSOCIATES OF MONTGOMERY, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. CAROLYN STONE BARRETT (OFFICE MANAGER)
(334) 396-8774
Entity
Organization

Contact information

Practice address
286 MITYLENE PARK DR, MONTGOMERY, AL 36117-3548
(334) 396-1555
(334) 396-9833
Mailing address
PO BOX 241627, MONTGOMERY, AL 36124-1627
(334) 396-1555
(334) 396-9833

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
10825
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
528501290
AL
01
CM4358
RAILROAD MEDICARE
AL
Enumeration date
12/19/2011
Last updated
12/19/2012
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