Georgia Mountain Dermatology, Llc

NPI 1043400088 - Dermatology - 207N00000X

NPI Details
NPI 1043400088
Enumeration Date 07/26/2007
Last Updated 07/26/2007
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name CARLTON TRENT CARLTON
Position PRESIDENT
Phone (706) 253-3376
Fax
Practice Location
150 INTERSTATE SOUTH DRIVE
SUITE 100
JASPER GA, 30143, US
Phone (706) 253-3376
Fax
Business Location
150 INTERSTATE SOUTH DRIVE
SUITE 100
JASPER GA, 30143, US
Phone
Fax
Toxanomy
Taxonomy Code 207N00000X
License State Georgia
License Number 033322
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According to our database, Georgia Mountain Dermatology, Llc NPI is 1043400088, taxonomy code is 207N00000X and license number is 033322, license state is located at Georgia. Georgia Mountain Dermatology, Llc physically located at 150 Interstate South Drive, Jasper GA, 30143. NPI Number 1033115704 has the healthcare provider type.

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1043400088 NPI number is provided on an as is basis without warranty of any kind. 1043400088 is maintained by the National Plan & Provider Enumeration System. The contents of Georgia Mountain Dermatology, Llc are for informational purposes only.