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Contact Information

LIVE OAK DERMATOLOGY
135 NORCROSS ST # 8
ROSWELL, GA30075-3867
 Phone: 678-870-2020
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dermatology

207N00000X 07 Physician/Dermatology
Indicates primary specialty

NPI Profile & details for LIVE OAK DERMATOLOGY

NPI # 1194209163
LBN Legal business name LIVE OAK DERMATOLOGY
Authorized official BRENT GOEDJEN - (CEO)
Entity Organization
Organization subpart 1 No
Enumeration date 09/17/2018
Last updated 07/22/2022 - About 4 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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