ADVANCED DERMATOLOGY, INC (NPI# 1750466934) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750466934 |
| Entity Type | Organization |
| Organization Name | ADVANCED DERMATOLOGY, INC |
| Practice Address |
1030 E Washington Ave Mcalester OK 74501-4850 |
| Practice Telephone | 9184261616 |
| Practice Fax Number | 9184262808 |
| Mailing Telephone | 9184261616 |
| Mailing Fax Number | 9184262808 |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2011-10-03 |
| Authorized Official Name | GARY K AUGTER (OWNER) |
| Authorized Official Telephone | 9184261616 |
| 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 |
3536 | OK | Allopathic & Osteopathic Physicians |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Massachusetts Corporations | ADVANCED DERMATOLOGY, INC. | 255 Park Ave, Suite 600, Worcester, MA 01609 |
| Street Address |
1030 E WASHINGTON AVE |
| City | MCALESTER |
| State | OK |
| Zip Code | 74501-4850 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114227360 | Onsite Medical, Pllc | Podiatrist | 1030 E Washington Ave, Mcalester, OK 74501-4850 | 2010-10-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295371466 | Belfair of Mcalester LLC | Assisted Living Facility | 802 Windsong Way, Mcalester, OK 74501 | 2019-11-22 |
| 1912425018 | Jennifer Bird | Case Manager/Care Coordinator | 34 Harpoon Dr, Mcalester, OK 74501 | 2017-09-08 |
| 1073033502 | Natalie Aline Kitchell | Case Manager/Care Coordinator | 1303 Hickory Bend, Mcalester, OK 74501 | 2017-06-26 |
| 1265964308 | Phoenix Counseling and Assessment Center, Inc. | Community/Behavioral Health | 32 E Cherokee, Suite 104, Mcalester, OK 74501 | 2017-03-29 |
| 1215302799 | Christine Herron | Physical Therapy Assistant | 1029 E. Washington Ave, Mcalester, OK 74501 | 2015-12-09 |
| 1437538212 | Lauren White | Speech-Language Pathologist | 205 South 2nd, Mcalester, OK 74501 | 2015-05-26 |
| 1316344096 | Ashley Brooke Monks | Speech-Language Pathologist | 557 Broken Feather Lane, Mcalester, OK 74501 | 2014-11-25 |
| 1821407644 | William Joseph Kinderknecht | Family Medicine | 4 E. Clark Bass Blvd., Suite 301a, Mcalester, OK 74501 | 2014-08-06 |
| 1467795153 | Kensey Mckay Holman | Occupational Therapist | 903 E Monroe Ave Ste 200, Mcalester, OK 74501 | 2013-04-01 |
| 1821334418 | Delors J Simmons | Counselor | 600 North D St, Mcalester, OK 74501 | 2012-12-31 |
| Find all providers in zip 74501 | ||||
| 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 |
|---|---|---|---|---|
| 1285647586 | Scott William Meyers | Dermatology | 1440 Terrace Dr, Tulsa, OK 74104-4626 | 2006-08-15 |
| 1124038518 | Mary Margaret Christian-reed | Dermatology | 9306 S Toledo Ct, Suite #100, Tulsa, OK 74137-2746 | 2006-08-08 |
| 1962061440 | Skin Cancer Center, Pllc | Dermatology | 2404 Palmer Cir, Norman, OK 73069-6301 | 2019-06-10 |
| 1104291236 | Oklahoma Cancer Specialists and Research Institute LLC | Dermatology | 800 W Boise Cir Ste 400, Broken Arrow, OK 74012-4974 | 2015-12-01 |
| 1023378759 | Robert Fischer | Dermatology | 5801 E 41st St Ste 200, Tulsa, OK 74135-5627 | 2012-05-29 |
| 1831349281 | Susannah L Collier Md Pllc | Dermatology | 3705 W Memorial Rd, Suite 101, Oklahoma City, OK 73134-1512 | 2008-09-23 |
| 1942335773 | Dermatology and Laser Center of Oklahoma | Dermatology | 9306 S Toledo Ct, Suite #100, Tulsa, OK 74137-2746 | 2007-02-22 |
| 1932286069 | Oklahoma Skin Surgery & Cosmetic Dermatology, P.C. | Dermatology | 1440 Terrace Dr, Tulsa, OK 74104-4626 | 2006-11-01 |
| 1598776866 | James B. Stewart, Jr., M.d., P.C. | Dermatology | 3705 W Memorial Rd, Suite 101, Oklahoma City, OK 73134-1512 | 2006-08-11 |
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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.