South Tyler Dermatology in Tyler - Specialist
South Tyler Dermatology - NPI 1568661908
South Tyler Dermatology is a Specialist in Tyler, Texas. South Tyler Dermatology practices all healthcare services and medical treatments related to Specialist. The NPI Number for South Tyler Dermatology is 1568661908. The last update date is 2007-07-16.
South Tyler Dermatology's current location address is 5791 Copeland Rd, Tyler, Texas. You can contact this provider via phone number 9035092020 and fax number 9035092355. The mailing address for South Tyler Dermatology is 5791 Copeland Rd, Tyler, Texas. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | South Tyler Dermatology |
|---|---|
| Address | 5791 Copeland Rd, Tyler, Texas |
| Phone Number | 9035092020 |
| Fax Number | 9035092355 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PHYSCIAN/ |
|---|---|
| Authorized Official Name | Beckley Dannise |
| Credentials | M.D |
| Telephone Number | 9035092020 |
NPI Number Detail
| NPI Number | 1568661908 |
|---|---|
| Provider Enumeration Date | 2007-07-16 |
| Last Updated Date | 2007-07-16 |
Provider Mailing Address Detail
| Address | 5791 Copeland Rd |
|---|---|
| City | Tyler |
| State | Texas (TX) |
| Post Code | 757033905 |
| Phone Number | 9035092020 |
| Fax Number | 9035092355 |
Provider's Primary Taxonomy Detail
| Speciality | Specialist |
|---|---|
| Taxonomy | 174400000X |
| Licence No | H2238 |
|
Definition: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
|
Post Comment/ Review Below
What is the unique 10-digit identifier code assigned to South Tyler Dermatology by the Centers for Medicare & Medicaid Services?
The South Tyler Dermatology has been issued the NPI (National Provider Identifier) 1568661908 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Can you provide the South Tyler Dermatology's physical address?
The South Tyler Dermatology is physically located at 5791 Copeland Rd, in the city of Tyler, TX, with the postal code 757033905.
What is the South Tyler Dermatology's area of specialization and corresponding taxonomy classification?
The South Tyler Dermatology's specialty field is Specialist, and it falls under the taxonomy code 174400000X, which categorizes healthcare providers based on their specialties.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1568661908 to South Tyler Dermatology?
The Centers for Medicare & Medicaid Services originally issued the 1568661908 to South Tyler Dermatology on 2007-07-16.
When was the information related to South Tyler Dermatology most recently updated or refreshed?
The details pertaining to the South Tyler Dermatology, including its address, specialty, and other relevant information, were last updated or refreshed on 2007-07-16.