Premier Dermatology & Skin Renewal Center
LBN: Premier Dermatology & Skin Renewal Center
Premier Dermatology & Skin Renewal Center is an health care organization with primary practice located at 909 Se 28Th St Ste 5, Bentonville AR 72712-3880. The organization recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatology, Allopathic & Osteopathic Physicians / Pediatric Dermatology, Allopathic & Osteopathic Physicians / Procedural Dermatology, Allopathic & Osteopathic Physicians / Clinical & Laboratory Dermatological Immunology. Allopathic & Osteopathic Physicians / Dermatology is the primary health care specialty.
Premier Dermatology & Skin Renewal Center can be contacted via phone (479) 273-3376, or through Clifton, Jeff via phone (479) 273-3376.
Contact Information
Primary practice address
909 Se 28Th St Ste 5
Bentonville AR 72712-3880
Phone: (479) 273-3376
Fax: (479) 273-3468
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | E3363 | Arkansas |
| Allopathic & Osteopathic Physicians / Pediatric Dermatology | 207NP0225X | E3363 | Arkansas |
| Allopathic & Osteopathic Physicians / Procedural Dermatology | 207NS0135X | E3363 | Arkansas |
| Allopathic & Osteopathic Physicians / Clinical & Laboratory Dermatological Immunology | 207NI0002X | Arkansas |
Profile Details
| NPI number | 1912912361 |
|---|---|
| LBN Legal business name | Premier Dermatology & Skin Renewal Center |
| DBA Doing business as | |
| Authorized official | Clifton, Jeff |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jul 31st, 2006 |
| Last updated | Aug 22nd, 2020 - about 5 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1912912361 | NPPES |
| Arkansas | Other | 1679521405 | NPI - MILDRED CLIFTON, MD |
| Arkansas | Other | 03060015000 | NPI - MILDRED CLIFTON, MD |
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