SOUTHEASTERN SKIN CANCER & DERMATOLOGY (NPI# 1538433602) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538433602 |
| Entity Type | Organization |
| Organization Name | SOUTHEASTERN SKIN CANCER & DERMATOLOGY |
| Practice Address |
124 County Road 3401 Haleyville AL 35565-6959 |
| Practice Telephone | 8593514994 |
| Enumeration Date | 2012-03-06 |
| Last Update Date | 2012-03-09 |
| Authorized Official Name | DR. ALBERT E RIVERA (PRESIDENT) |
| Authorized Official Telephone | 8593514994 |
| Authorized Official Credential | D.O. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
DO987 | AL | Allopathic & Osteopathic Physicians |
| Street Address |
124 COUNTY ROAD 3401 |
| City | HALEYVILLE |
| State | AL |
| Zip Code | 35565-6959 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669715165 | Judith Ann Reynolds | Pharmacist | 2323 15th Ave, Haleyville, AL 35565 | 2013-04-03 |
| 1578879482 | Beth K Moore | Physical Therapist | 42445 Highway 195 East, Village East Shopping Center, Haleyville, AL 35565 | 2010-08-30 |
| 1043549306 | Jane Ann D Gilbert | Counselor | 71 Carraway Dr, Haleyville, AL 35565 | 2009-12-16 |
| 1285878462 | Amanda Jean Godsey | Family Medicine | 1023 Hwy 13, Haleyville, AL 35565 | 2009-05-01 |
| 1083808745 | More Than Words Speech Pathology Services, LLC | Speech-Language Pathologist | 1713 21st Street, Haleyville, AL 35565 | 2007-09-05 |
| 1780704270 | Charles H Banks Jr. | Dentist | 2095 20th Avenue, Haleyville, AL 35565 | 2007-03-30 |
| 1306962352 | Kimeron L Robertson | Physical Therapist | 42445 Hwy 195 E, Village East Shopping Center, Haleyville, AL 35565 | 2007-03-21 |
| 1396831855 | Amy Boshell | Chiropractor | 8177 Hwy 13, Haleyville, AL 35565 | 2006-10-04 |
| 1417041047 | Vanessa Ann Ragland | Family Medicine | 42320 Highway 195, Haleyville, AL 35565 | 2006-10-03 |
| 1679670814 | Dan M Lakeman | Dentist | 1001 Hwy 13, Haleyville, AL 35565 | 2006-09-20 |
| Find all providers in zip 35565 | ||||
| Taxonomy Code | 207ND0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | MOHS-Micrographic Surgery |
| The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S. |
| Notes: Source: American College of Mohs Surgery, 2007 [1/1/2008: added definition, added source] Additional Resources: Additional Resources: http://www.mohscollege.org/; American Board of Dermatology, 2007. http://www.abderm.org/ |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588851125 | Tony Adar | Dermatology | 2100 16th Ave S Ste 202, Birmingham, AL 35205 | 2007-09-27 |
| 1366583882 | Albert Earl Rivera | Dermatology | 8331 Madison Blvd, Suite 300, Madison, AL 35758-2070 | 2007-02-08 |
| 1679658256 | R. Gordon Mowry, M.d. | Dermatology | 100 Memorial Hospital Dr Ste 2b, Mobile, AL 36608-1129 | 2006-10-25 |
| 1952410177 | George G Tisdale | Dermatology | 425 Montgomery Hwy, Birmingham, AL 35216-1805 | 2006-08-30 |
| 1174565493 | Adam C. Esser | Dermatology | 2100 16th Ave S, Suite 202, Birmingham, AL 35205-5021 | 2006-06-12 |
| 1255320115 | Julian Murphree Thomas | Dermatology | 3940 Montclair Rd, Suite 410, Birmingham, AL 35213-2427 | 2005-10-13 |
| 1346855327 | Forefront Dermatology, S.c. | Dermatology | 2471 Helton Dr, Florence, AL 35630-1067 | 2020-09-15 |
| 1538773775 | Advanced Dermatology of Alabama, Inc. | Dermatology | 286 Mitylene Park Dr, Montgomery, AL 36117-3548 | 2020-09-04 |
| 1194289181 | Forefront Dermatology, S.c. | Dermatology | 202 Rock Creek Pkwy, Fairhope, AL 36532-3349 | 2019-01-24 |
| 1497235592 | Forefront Dermatology, S.c. | Dermatology | 250 Inverness Center Dr, Birmingham, AL 35242 | 2018-08-17 |
| Find all providers with the same taxonomy | ||||
| City | HALEYVILLE |
| Zip Code | 35565 |
Please comment or provide details below to improve the information on SOUTHEASTERN SKIN CANCER & DERMATOLOGY.
| 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.