The Dermatology Clinic, Pllc
LBN: The Dermatology Clinic, Pllc
The Dermatology Clinic, Pllc is an health care organization with primary practice located at 11295 East Taylor Road , Gulfport MS 39503. The organization recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Dermatology. Allopathic & Osteopathic Physicians / Dermatology is the primary health care specialty.
The Dermatology Clinic, Pllc can be contacted via phone (228) 864-3300, or through Wingfield, Angela B via phone (228) 864-3300.
Contact Information
Primary practice address
11295 East Taylor Road
Gulfport MS 39503
Phone: (228) 864-3300
Fax: (228) 864-3333
Website:
Authorized official contact:
Name: Wingfield, Angela B Doctor of Medicine (MD)
Phone: (228) 864-3300
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | 17831 | Texas |
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X |
Profile Details
| NPI number | 1720284946 |
|---|---|
| LBN Legal business name | The Dermatology Clinic, Pllc |
| DBA Doing business as | |
| Authorized official | Wingfield, Angela B Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jun 25th, 2007 |
| Last updated | Feb 24th, 2023 - about 2 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 | 1720284946 | NPPES |
| Other | 25D1013637 | CLIA | |
| MEDICAID | 06375287 | CLIA | |
| MEDICAID | 00874879 | CLIA |
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