ADVANCED DERMATOLOGY & SKIN CANCER CENTER, LLC (NPI# 1245426162) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245426162 |
| Entity Type | Organization |
| Organization Name | ADVANCED DERMATOLOGY & SKIN CANCER CENTER, LLC |
| Practice Address |
1444 E Stearns St Suite 11 Fayetteville AR 72703-6243 |
| Practice Telephone | 4797187546 |
| Practice Fax Number | 4799664979 |
| Mailing Telephone | 4797187546 |
| Mailing Fax Number | 4799664979 |
| Enumeration Date | 2007-09-25 |
| Last Update Date | 2012-08-29 |
| Authorized Official Name | DR. LANCE BRANDON HENRY (DIRECTOR) |
| Authorized Official Telephone | 4798568494 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| Street Address |
1444 E STEARNS ST SUITE 11 |
| City | FAYETTEVILLE |
| State | AR |
| Zip Code | 72703-6243 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679682520 | Lance B. Henry | Dermatology | 1444 E Stearns St, Suite 11, Fayetteville, AR 72703-6243 | 2006-08-30 |
| 1558784728 | Ryan Crowder | Physician Assistant | 1444 E Stearns St, Fayetteville, AR 72703-6243 | 2014-01-24 |
| 1053606145 | Emily Lindsay Staggs | Nurse Practitioner | 1444 E Stearns St, Fayetteville, AR 72703-6243 | 2011-06-16 |
| 1326228370 | Advanced Ambulatory Surgery Center, LLC | Clinic/Center | 1444 E Stearns St, Suite 15, Fayetteville, AR 72703-6243 | 2007-11-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477154391 | Margaret Sorrells | Pharmacist | 3909 N Mall Ave Attn:pharmacy, Fayetteville, AR 72703 | 2020-11-06 |
| 1497369631 | Justin A Rand | Massage Therapist | 88 W Colt Square Dr, Fayetteville, Ar 72703, Fayetteville, AR 72703 | 2020-09-04 |
| 1235777558 | Washington Regional Medical System | Specialist | 3264 N North Hills Blvd, Fayetteville, AR 72703 | 2019-12-17 |
| 1760024582 | Haley Brooke Thompson | Occupational Therapist | 2474 E Joyce Blvd Ste 2, Null, Fayetteville, AR 72703 | 2019-10-14 |
| 1306492129 | Bhg L, LLC | Clinic/Center | 8 Colt Square Drive, Fayetteville, AR 72703 | 2019-08-16 |
| 1306406269 | Idell Marie Mitchell | Optometrist | Eye Clinic, 1100 N College Ave, Fayetteville, AR 72703 | 2019-06-13 |
| 1821574815 | Toni Myer | Nurse Practitioner | 3 E Appleby Rd Ste 101, Fayetteville, AR 72703 | 2018-07-13 |
| 1306340393 | Josh Kelfer | Student in an Organized Health Care Education/Training Program | 1125 North College Avenue, Fayetteville, AR 72703 | 2018-03-22 |
| 1649726449 | Vantage Point of Nwa | Community/Behavioral Health | 4171 N. Crossover Rd, Fayetteville, AR 72703 | 2016-08-31 |
| 1386097137 | Jason Nordstrom | Speech-Language Pathologist | 2664 N Valencia Ave, Fayetteville, AR 72703 | 2016-07-18 |
| Find all providers in zip 72703 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124683032 | Red Earth Acupuncture | Clinic/Center | 1836 Highway 54 W, Fayetteville, GA 30214-4742 | 2019-05-06 |
| 1477033728 | Swetnam Cosmetic Surgery, Pllc | Clinic/Center | 1695 E Rainforest Rd Ste 3, Fayetteville, AR 72703-5385 | 2018-08-16 |
| 1023500725 | Greenbrook Tms Fayetteville LLC | Clinic/Center | 1991 Fordham Dr Ste 202, Fayetteville, NC 28304-3774 | 2018-05-30 |
| 1871013367 | Shiloh Health and Longevity | Clinic/Center | 1794 E Joyce Blvd Ste 1, Fayetteville, AR 72703-5257 | 2017-06-26 |
| 1942687900 | St Marys Hca of South Carolina | Clinic/Center | 2603 Cumberland Gap Drive, Suite 203, Fayetteville, NC 28306 | 2015-04-29 |
| 1407017965 | Correctiona Medical Associates | Clinic/Center | 205 Mcintosh Place Dr, Fayetteville, GA 30214-7384 | 2008-06-18 |
| 1376728154 | Massage Therapeutics, Inc Center for Wellness | Clinic/Center | 500 Lanier Ave W Ste 411, Fayetteville, GA 30214-7638 | 2007-12-30 |
| 1578767299 | Kidzplex Fitness | Clinic/Center | 1830q Owen Dr, Fayetteville, NC 28304-3421 | 2007-06-14 |
| 1114067519 | Rediclinic LLC | Clinic/Center | 3911 North Mall Avenue, Fayetteville, AR 72703 | 2007-02-07 |
| 1932202447 | Appalachian Regional Healthcare | Clinic/Center | 436 Elizabeth Way, Fayetteville, WV 25840 | 2006-09-07 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 72703 |
Please comment or provide details below to improve the information on ADVANCED DERMATOLOGY & SKIN CANCER CENTER, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.