Wyatt, Samantha S
Wyatt, Samantha S is an individual health care provider with primary practice located at 620 Walnut St Ne Suite A, Decatur AL 35601-2456. She recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as her primary health care specialty. Wyatt, Samantha S can be contacted via phone (256) 353-7775.Contact Information
Primary practice address
620 Walnut St Ne Suite A
Decatur AL 35601-2456
Phone: (256) 353-7775
Fax: (256) 353-7765
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | 00026547 | Alabama |
Profile Details
| NPI number | 1942247150 |
|---|---|
| LBN Legal business name | Wyatt, Samantha S |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 31st, 2006 |
| Last updated | Dec 18th, 2013 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1942247150 | NPPES |
| Alabama | MEDICAID | 009932289 | |
| Alabama | Other | 51001088 | |
| Alabama | MEDICAID | 529924440 |
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