Dermatolgy & Dermatologic Surgery Pc
LBN: Dermatolgy & Dermatologic Surgery Pc
Dermatolgy & Dermatologic Surgery Pc is an health care organization with primary practice located at 1021 W Oakland Dr Suite 102, Johnson City TN 37604-0000. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as the primary health care specialty.
Dermatolgy & Dermatologic Surgery Pc can be contacted via phone (423) 928-9014, or through Hudson, Larry David via phone (423) 928-9014.
Contact Information
Primary practice address
1021 W Oakland Dr Suite 102
Johnson City TN 37604-0000
Phone: (423) 928-9014
Fax: (423) 928-3559
Website:
Authorized official contact:
Name: Hudson, Larry David Doctor of Medicine (MD)
Phone: (423) 928-9014
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | MD0000013019 | Tennessee |
Profile Details
| NPI number | 1427128511 |
|---|---|
| LBN Legal business name | Dermatolgy & Dermatologic Surgery Pc |
| DBA Doing business as | |
| Authorized official | Hudson, Larry David Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Nov 8th, 2006 |
| Last updated | Aug 22nd, 2020 - about 6 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1427128511 | NPPES |
| Tennessee | Other | 0036521 | BCBS |
| Tennessee | MEDICAID | 3701830 | BCBS |
| Tennessee | Other | TN0101 | BCBS |
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