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
Fax: (423) 928-3559
Website:
Authorized official contact:
Name: Hudson, Larry David Doctor of Medicine (MD)

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1427128511 NPPES
Tennessee Other 0036521 BCBS
Tennessee MEDICAID 3701830 BCBS
Tennessee Other TN0101 BCBS

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