Southern Dermatology Llc

LBN: Southern Dermatology Llc
Southern Dermatology Llc is an health care organization with primary practice located at 2110 Woodside Executive Ct , Aiken SC 29803-3809. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as the primary health care specialty. Southern Dermatology Llc can be contacted via phone (803) 644-5779, or through Cook, John R via phone (803) 644-5779.

Contact Information

Primary practice address
2110 Woodside Executive Ct Aiken SC 29803-3809
Phone: (803) 644-5779
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Cook, John R Doctor of Medicine (MD)
Phone: (803) 644-5779

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 11685 South Carolina

Profile Details

NPI number 1821367046
LBN Legal business name Southern Dermatology Llc
DBA Doing business as
Authorized official Cook, John R Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Dec 16th, 2011
Last updated Dec 16th, 2011 - about 15 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 1821367046 NPPES
South Carolina MEDICAID GP2477

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