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Contact Information

DIAGNOSTIC DERMATOPATHOLOGY
2101 BROOKSTONE CENTRE PKWY
STE 300
COLUMBUS, GA31904-9254
 Phone: 706-256-1133
 Fax: 706-256-1136
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dermatopathology

207ND0900X 07 Physician/Dermatology
 

Dermatology

207N00000X 07 Physician/Dermatology
Indicates primary specialty

NPI Profile & details for DIAGNOSTIC DERMATOPATHOLOGY

NPI Number 1770958092
LBN Legal business name DIAGNOSTIC DERMATOPATHOLOGY
Authorized official LIAQAT ALI - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 12/11/2015
Last updated 01/11/2017 - About 9 years ago
Identifiers
GA License # 74802
GA Medicaid 003171345A
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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