National Provider Identifier Database

AUGUSTA CENTRE FOR DERMATOLOGY SKIN RENEWAL LLC
Medical Specialty

An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).


Contact Information

AUGUSTA CENTRE FOR DERMATOLOGY & SKIN RENEWAL LLC
3614 J DEWEY GRAY CIR
STE B
AUGUSTA, GA30909-6602
Phone: 706-447-3909
Fax:
Website:
Specialty Taxonomy Code
* Medical Specialty 261QM2500X

* Indicates primary specialty

NPI Profile & details for AUGUSTA CENTRE FOR DERMATOLOGY & SKIN RENEWAL LLC

NPI Number 1255702940
Legal business name
LBN
AUGUSTA CENTRE FOR DERMATOLOGY & SKIN RENEWAL LLC
Authorized official ANNE LOEBL - (OWNER)
Entity Organization
Organization subpart No
Enumeration date 10/07/2015
Last updated 10/07/2015 - About 11 years ago
Sole proprietor1 Not specified
Identifiers
  • GA License #: 022436

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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