DERMATOLOGY & SKIN CANCER PREVENTION CENTER, INC. (NPI# 1710213947) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710213947 |
| Entity Type | Organization |
| Organization Name | DERMATOLOGY & SKIN CANCER PREVENTION CENTER, INC. |
| Practice Address |
1215 Eagles Landing Parkway Suite 205 Stockbridge GA 30281-7280 |
| Practice Telephone | 7703899116 |
| Practice Fax Number | 7705064580 |
| Mailing Telephone | 7703899116 |
| Mailing Fax Number | 7705064580 |
| Enumeration Date | 2009-10-22 |
| Last Update Date | 2011-03-23 |
| Authorized Official Name | DAVID S. BRYANT (OWNER) |
| Authorized Official Telephone | 7703899116 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 174400000X | Specialist | 005538 | GA | Other Service Providers |
| Y | 174400000X | Specialist | 052394 | GA | Other Service Providers |
| Street Address |
1215 EAGLES LANDING PARKWAY SUITE 205 |
| City | STOCKBRIDGE |
| State | GA |
| Zip Code | 30281-7280 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295729952 | Thomas R Fitzsimmons | Specialist | 1215 Eagles Landing Parkway, Suite 105, Stockbridge, GA 30281-3707 | 2005-09-08 |
| 1649516006 | Dr. Thomas R Fitzsimmons Md PC | Surgery | 1215 Eagles Landing Parkway, Suite 105, Stockbridge, GA 30281 | 2012-12-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164039095 | Colette Alls | Social Worker | 447 Lakeshore Dr, Stockbridge, GA 30281 | 2020-09-24 |
| 1982216800 | Pediatric and Family Behavioral Health of Georgia | Counselor | 1004 Ulster Court, Stockbridge, GA 30281 | 2020-08-21 |
| 1518577659 | Qunique Taveka Toxey | Behavior Technician | 115 N Park Trail, Suite 123, Stockbridge, GA 30281 | 2020-08-04 |
| 1497377675 | Melanie Harvey | Pharmacist | 4467 North Henry Boulevard, Stockbridge, GA 30281 | 2020-05-11 |
| 1114550571 | Cecile Maria Dunkley Layne | Counselor | 255 Corporte Drive, Stockbridge, GA 30281 | 2020-02-13 |
| 1306407143 | Palliative Care of Georgia. LLC | Home Health | 275 Corporate Center Court Ste C, Stockbridge, GA 30281 | 2019-06-24 |
| 1154883791 | Aaliyah Nura Fardan-alexander | Nurse's Aide | 105 Singletree, Stockbridge, GA 30281 | 2019-04-02 |
| 1306306261 | Prosthetic Care, Inc. | Prosthetic/Orthotic Supplier | 150 County Club Drive, Suite 200, Stockbridge, GA 30281 | 2019-03-25 |
| 1356814172 | Kristina Louissaint | Nurse Practitioner | 650 Country Club Dr, Stockbridge, GA 30281 | 2019-01-03 |
| 1942789284 | Cameren Barnes | Physical Therapist | 5473 N Henry Blvd, Stockbridge, GA 30281 | 2018-08-08 |
| Find all providers in zip 30281 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386094852 | David S. Bryant | Specialist | 1215 Eagle Lndng Pkwy, Stockbridge, GA 30281-7279 | 2016-06-15 |
| 1700160611 | Melissa Deluke Falk | Specialist | 307 Joe Manning Rd, Stockbridge, VT 05772-9807 | 2011-10-11 |
| 1669663365 | Center of Hope for Cancers and Blood Disorders | Specialist | 7444 Hannover Pkwy, Suite 150, Stockbridge, GA 30281 | 2007-08-07 |
| 1952518698 | Southern Crescent Womens Health Specialists At Eagle's Landing | Specialist | 1050 Eagles Landing Pkwy Ste 302, Stockbridge, GA 30281-9250 | 2007-05-16 |
| 1730240227 | Robert B Friedman | Specialist | 900 Eagles Landing Pkwy, Stockbridge, GA 30281 | 2006-12-12 |
| 1447335690 | Chelsea Professional Services | Specialist | 4525 S M 52, Stockbridge, MI 49285-9465 | 2006-10-26 |
| 1861406506 | John Howard Greenfield | Specialist | 1035 Southcrest Dr, Suite 100, Stockbridge, GA 30281-6114 | 2006-07-28 |
| 1831157932 | Subramanyam K Naidu | Specialist | 226 Willis Dr, Stockbridge, GA 30281-7272 | 2006-05-01 |
| 1184696973 | Mark Alan Kozinn | Specialist | 135 N Park Pl Ste 200, Stockbridge, GA 30281-7209 | 2006-02-06 |
| 1316921059 | Rayasam V. Prasad | Specialist | 1520 Rock Quarry Rd, Stockbridge, GA 30281-7386 | 2005-12-06 |
| Find all providers in STOCKBRIDGE | ||||
| City | STOCKBRIDGE |
| Zip Code | 30281 |
Please comment or provide details below to improve the information on DERMATOLOGY & SKIN CANCER PREVENTION CENTER, INC..
| 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.