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Contact Information

RENEW FAMILY DERMATOLOGY LLC
212 AIRPORT ROAD W
FORT PAYNE, AL35968
 Phone: 256-979-1250
 Fax: 256-979-1251
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dermatology

207N00000X 07 Physician/Dermatology
 

Medical Specialty

261QM2500X
Indicates primary specialty

NPI Profile & details for RENEW FAMILY DERMATOLOGY LLC · (Female)

NPI Number 1275198913
Status Active
Credentials
Entity Individual
Enumeration date 05/08/2019
Last updated 03/05/2026 - About 3 months ago
Sole proprietor 1 Not specified
Identifiers
  • AL Medicaid 236456
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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