Family Dermatology, P.C.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

FAMILY DERMATOLOGY, P.C.

Practice address

629 Beaver Ruin Rd NW
Suite B
Lilburn, GA 30047-3401

Phone

(770) 921-4300

Fax

(770) 381-6451

NPI assigned

Apr 9, 2008

Last updated

May 27, 2009By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dele Yudowi

Title

Manager

Phone

(770) 231-5279

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1207699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1243382400000",
    "number": "1144493396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "629 BEAVER RUIN RD NW",
            "address_2": "SUITE B",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300473401",
            "telephone_number": "770-921-4300",
            "fax_number": "770-381-6451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "629 BEAVER RUIN RD NW",
            "address_2": "SUITE B",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300473401",
            "telephone_number": "770-921-4300",
            "fax_number": "770-381-6451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY DERMATOLOGY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-09",
        "last_updated": "2009-05-27",
        "status": "A",
        "authorized_official_last_name": "YUDOWI",
        "authorized_official_first_name": "DELE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "770-231-5279"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Billie Jean Faust, LPC

• Dermatology Physician in Lilburn, GA
• Providers in Lilburn, GA by specialty
• Dermatology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.