Dermatology Clinic S.C.
LBN: Dermatology Clinic S.C.
Dermatology Clinic S.C. is an health care organization with primary practice located at 715 Superior Rd Ste 120 , Green Bay WI 54311-7595. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatology, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Allopathic & Osteopathic Physicians / Dermatology is the primary health care specialty.
Dermatology Clinic S.C. can be contacted via phone (920) 406-9803, or through Zimmermann, Chris L via phone (920) 406-9803.
Contact Information
Primary practice address
715 Superior Rd Ste 120
Green Bay WI 54311-7595
Phone: (920) 406-9803
Fax: (920) 406-9934
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | ||
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 2187-023 | Wisconsin |
Profile Details
| NPI number | 1427079516 |
|---|---|
| LBN Legal business name | Dermatology Clinic S.C. |
| DBA Doing business as | |
| Authorized official | Zimmermann, Chris L PHD |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jul 22nd, 2006 |
| Last updated | Apr 19th, 2012 - about 14 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 | 1427079516 | NPPES |
| Wisconsin | MEDICAID | 21251100 |
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