THE DERMATOLOGY CLINIC, PLLC


Address: 11295 East Taylor Road, Gulfport, MS 39503
Phone: 2288643300

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 174400000X Specialist 17831 TX Other Service Providers
Y 207N00000X Dermatology Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
MS 00874879 05
MS 06375287 05
CLIA 25D1013637 01

Office Location

Street Address 11295 EAST TAYLOR ROAD
City GULFPORT
State MS
Zip Code 39503

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1447865985 Nicholas Wyrosdick Physical Therapist 12261 Us 49 #1, Gulfport, MS 39503 2020-09-11
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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
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Taxonomy Information

Taxonomy Code 207N00000X
Grouping Allopathic & Osteopathic Physicians
Classification Dermatology

Taxonomy Definition

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.

Providers in the same taxonomy and city

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

Providers in the same taxonomy and state

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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Competitor

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City GULFPORT
Zip Code 39503

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Dataset Information

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.

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