THE DERMATOLOGY CLINIC, PLLC (NPI# 1720284946) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1720284946 |
Entity Type | Organization |
Organization Name | THE DERMATOLOGY CLINIC, PLLC |
Practice Address |
11295 East Taylor Road Gulfport MS 39503 |
Mailing Address |
P.o. Box 6625 Gulfport MS 39506-6625 |
Practice Telephone | 2288643300 |
Practice Fax Number | 2288643333 |
Mailing Telephone | 2288643300 |
Mailing Fax Number | 2288643333 |
Enumeration Date | 2007-06-25 |
Last Update Date | 2020-05-06 |
Authorized Official Name | DR. ANGELA B WINGFIELD (OWNER/PHYSICIAN) |
Authorized Official Telephone | 2288643300 |
Authorized Official Credential | MD |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 174400000X | Specialist | 17831 | TX | Other Service Providers |
Y | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MS | 00874879 | 05 | |
MS | 06375287 | 05 | |
CLIA | 25D1013637 | 01 |
Street Address |
11295 EAST TAYLOR ROAD |
City | GULFPORT |
State | MS |
Zip Code | 39503 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1013515451 | Gulf Coast Neurospa, LLC | Psychiatry & Neurology | 8845 Lorraine Road, Gulfport, MS 39503 | 2020-10-16 |
1447865985 | Nicholas Wyrosdick | Physical Therapist | 12261 Us 49 #1, Gulfport, MS 39503 | 2020-09-11 |
1750935169 | Ladner Roy Drugs, LLC. | Pharmacy | 12261 Us 49 Suite 16, Gulfport, MS 39503 | 2019-07-25 |
1528559440 | Alexander Therapy Services, LLC | Clinic/Center | 15465 Oak Ln Ste 100c, Gulfport, MS 39503 | 2018-05-25 |
1750879003 | Heather Lynn Theisen | Nurse Practitioner | 15190 Community Rd Ste 330, Gulfport, MS 39503 | 2018-04-23 |
1083101216 | Gulf Coast Mental Health Center | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 15094 County Barn Road, Gulfport, MS 39503 | 2018-04-13 |
1306343173 | Dr. Raymond Monsour Scurfield, LLC | Community/Behavioral Health | 15465 Oak Lane Ste 100-g, Gulfport, MS 39503 | 2018-04-09 |
1952817157 | Mary Beth Welch | Behavioral Analyst | 9230 Old Lorraine Rd, Gulfport, MS 39503 | 2017-12-26 |
1831603257 | Beach View Family Dental, Pllc | Dentist | 9072 Lorraine Road, Gulfport, MS 39503 | 2017-11-21 |
1437677721 | Mary Stephens Ruffin | Social Worker | 11262 Creek Dr, Gulfport, MS 39503 | 2017-09-07 |
Find all providers in zip 39503 |
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 |
---|---|---|---|---|
1821285438 | Tulane Dermatology Affiliates | Dermatology | 1245 42nd Avenue, Gulfport, MS 39501 | 2007-09-27 |
1912090143 | Alan Lewis | Dermatology | 1245 42nd Ave, Gulfport, MS 39501-2666 | 2006-10-02 |
1225040819 | Robert C Wessler | Dermatology | 1118 Broad Ave, Gulfport, MS 39501-2414 | 2006-08-12 |
1376532788 | Gulf Coast Dermatology, Pa | Dermatology | 1304 44th Ave, Gulfport, MS 39501-2552 | 2005-10-18 |
1609296698 | Bradley Saylors | Dermatology | 1245 42nd Ave, Gulfport, MS 39501-2666 | 2014-04-17 |
1417040213 | Joseph P. Shrum | Dermatology | 1245 42nd Ave, Gulfport, MS 39501-2666 | 2006-10-02 |
1417971094 | Gwendolyn Ann Crane | Dermatology | 1304 44th Ave, Gulfport, MS 39501-2552 | 2006-07-27 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1760043046 | Skin In The Game, Pllc | Dermatology | 6510 Highway 90, Gautier, MS 39553-5015 | 2019-06-26 |
1427535079 | Jenna Joe Rose Cooper | Dermatology | 2204 Jefferson Davis Dr, Oxford, MS 38655-5222 | 2018-07-26 |
1427460849 | Anna Allred Wile | Dermatology | 4331 Highway 39 N Ste A, Meridian, MS 39301-1007 | 2014-05-21 |
1134558331 | South Central Clinics, Inc | Dermatology | 920 Matthew Dr Ste 8, Waynesboro, MS 39367-2553 | 2013-11-07 |
1407296825 | Ashley Nicole Emerson | Dermatology | 6510 Highway 90 Ste C, Gautier, MS 39553-5015 | 2013-06-29 |
1265729719 | Jasmine C. Hollinger | Dermatology | 2080 S Frontage Rd Ste 113, Vicksburg, MS 39180-5882 | 2011-07-06 |
1295022861 | Kenneth Daniel Saul | Dermatology | 5002 Highway 39 N Bldg A, Meridian, MS 39301-1078 | 2011-07-05 |
1689969735 | Adam C Byrd | Dermatology | 313 N Court Ave, Ummc Dermatology - Louisville Clinic, Louisville, MS 39339 | 2011-06-16 |
1063724987 | Lyndsay R Shipp | Dermatology | 705 Sisk Ave Ste 105, Oxford, MS 38655-3413 | 2010-07-08 |
1144545195 | Lisa Renee Chastant | Dermatology | 81 Mdos/sgomd, 301 Fisher St., Keesler Afb, MS 39534-2519 | 2010-04-01 |
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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.