Organization
GULF COAST DERMATOLOGY & SKIN CARE CENTRE PLLC
Active
Other names
Advanced Dermatology & Skin Care Centre
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS W BENDER III MD (PHYSICIAN)
(251) 631-3570
Entity
Organization
Contact information
Practice address
6701 AIRPORT BLVD STE D232, MOBILE, AL 36608-6757
(251) 631-3570
(251) 631-3572
Mailing address
PO BOX 850489, STE. D232, MOBILE, AL 36685-0489
(251) 631-3570
(251) 631-3572
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
21520
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
116224
—
AL
Enumeration date
07/09/2015
Last updated
07/09/2015
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