GULF COAST DERMATOLOGY & SKIN CARE CENTRE PLLC (NPI# 1336523265) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336523265 |
| Entity Type | Organization |
| Organization Name | GULF COAST DERMATOLOGY & SKIN CARE CENTRE PLLC |
| Other Organization Name | ADVANCED DERMATOLOGY & SKIN CARE CENTRE |
| Practice Address |
580 Providence Park Dr E Mobile AL 36695-4614 |
| Practice Telephone | 2516313570 |
| Practice Fax Number | 2516313572 |
| Mailing Telephone | 2516313570 |
| Mailing Fax Number | 2516313572 |
| Enumeration Date | 2015-07-09 |
| Last Update Date | 2015-07-09 |
| Authorized Official Name | THOMAS W BENDER III (PHYSICIAN/AUTHORIZED OFFICIAL) |
| Authorized Official Telephone | 2516313570 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | 21520 | AL | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Advanced Dermatology & Skin Care Centre | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184078024 | Gulf Coast Dermatology & Skin Care Centre Pllc | Pharmacy | 580 Providence Park Dr E Ste 202, Suite 202, Mobile, AL 36695-4614 | 2016-04-18 |
| 1891179727 | Gulf Coast Dermatology & Skin Care Centre Pllc | Dermatology | 6701 Airport Blvd Ste D232, Mobile, AL 36608-6757 | 2015-07-09 |
| 1922346956 | Gulf Coast Dermatology & Skin Care Centre Pllc | Dermatology | 10800 Panama City Beach Pkwy, Suite 200, Panama City Beach, FL 32407-2533 | 2013-01-25 |
| 1750629788 | Gulf Coast Dermatology & Skin Care Centre Pllc | Dermatology | 4554 E Highway 20, Niceville, FL 32578-9755 | 2013-01-25 |
| 1205174232 | Gulf Coast Dermatology & Skin Care Centre Pllc | Dermatology | 7720 Us Highway 98 W, Suite 340, Miramar Beach, FL 32550-7230 | 2013-01-25 |
| 1750614301 | Gulf Coast Dermatology & Skin Care Centre Pllc | Dermatology | 580 Providence Park Dr E, Second Floor, Mobile, AL 36695-4614 | 2009-09-15 |
| Street Address |
580 PROVIDENCE PARK DR E |
| City | MOBILE |
| State | AL |
| Zip Code | 36695-4614 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649266792 | Thomas W Bender IIi | Dermatology | 580 Providence Park Dr E, 2nd Floor, Mobile, AL 36695-4614 | 2005-09-23 |
| 1235609744 | Edith Royal Cheney | Social Worker | 580 Providence Park Dr E, Mobile, AL 36695-4614 | 2018-11-27 |
| 1750614301 | Gulf Coast Dermatology & Skin Care Centre Pllc | Dermatology | 580 Providence Park Dr E, Second Floor, Mobile, AL 36695-4614 | 2009-09-15 |
| 1265666820 | Virginia Jones Reeder | Dermatology | 580 Providence Park Dr E, 2nd Floor, Mobile, AL 36695-4614 | 2009-05-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629677596 | Linda Jean Hayes | Counselor | 2146 Carson Court, Mobile, AL 36695 | 2020-10-22 |
| 1205447836 | Restore Therapy Services, Ltd | Physical Therapist | 6720 Grejot Road, Mobile, AL 36695 | 2020-08-17 |
| 1437774999 | Nicholas Alan Brautigam | Chiropractor | 960 Schillinger Rd S, Suite D, Mobile, AL 36695 | 2020-06-10 |
| 1891320412 | R3 Counseling Solutions, LLC | Social Worker | 1110 Hillcrest Road, Suite 1b, Mobile, AL 36695 | 2020-03-04 |
| 1649800079 | Tondalaya Denise Mack | Home Health | 1450 Leroy Stevens Rd, Apt35, Mobile, AL 36695 | 2020-01-24 |
| 1801367107 | Tera Walters Therapy LLC | Pediatrics | 2523 D'iberville Drive North, Mobile, AL 36695 | 2018-12-12 |
| 1023595279 | Hall & Oates Pt West Mobile, LLC | Physical Therapist | 2351 Dawes Road, Mobile, AL 36695 | 2018-07-20 |
| 1679069116 | Oculo-facial Consultants | Ophthalmology | 610 Providence Park Dr E Bldg 2, Mobile, AL 36695 | 2018-07-09 |
| 1669964318 | Tina Highsmith | Hearing Instrument Specialist | 2344 Schillinger Rd S, Building #2 Ste A, Mobile, AL 36695 | 2018-05-30 |
| 1023533858 | Reach Pediatric Therapy | Speech-Language Pathologist | 12485 Jeff Hamilton Rd, Mobile, AL 36695 | 2017-08-14 |
| Find all providers in zip 36695 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891179727 | Gulf Coast Dermatology & Skin Care Centre Pllc | Dermatology | 6701 Airport Blvd Ste D232, Mobile, AL 36608-6757 | 2015-07-09 |
| 1851447460 | Scott Freeman | Dermatology | 70 Midtown Park E, Mobile, AL 36606-4140 | 2007-01-26 |
| 1487755328 | Aldo Trovato | Dermatology | 3715 Dauphin Street Building 2, 4th Floor, Mobile, AL 36608-1771 | 2006-09-25 |
| 1477577757 | Robert Neil Capper | Dermatology | 5317 Oak Bend Ct, Mobile, AL 36609-2202 | 2006-07-27 |
| 1366471286 | John Scott Vanloock | Dermatology | 6163 Omni Park Dr, Mobile, AL 36609-5195 | 2006-07-02 |
| 1700826443 | Roberta G Swain | Dermatology | 3153 Dauphin St, Mobile, AL 36606-4061 | 2006-06-08 |
| 1912985243 | Amy M Morris | Dermatology | 4310 Old Shell Rd, D, Mobile, AL 36608-2049 | 2006-01-06 |
| 1649266792 | Thomas W Bender IIi | Dermatology | 580 Providence Park Dr E, 2nd Floor, Mobile, AL 36695-4614 | 2005-09-23 |
| 1891798807 | Belin Fred Bodie | Dermatology | 4300 Old Shell Rd, Ste B, Mobile, AL 36608-2036 | 2005-05-23 |
| 1255994141 | University of South Alabama Health Care Authority | Dermatology | 4300 Old Shell Rd Ste B, Mobile, AL 36608-2036 | 2019-04-17 |
| Find all providers in MOBILE | ||||
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| 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.