John L Proffitt MD PA

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

JOHN L PROFFITT MD PA

Doing business as

Oak Lawn Dermatology

Practice address

3500 Oak Lawn Ave
Suite 650
Dallas, TX 75219-4308

Phone

(214) 526-8100

Fax

(214) 526-8105

NPI assigned

Jan 5, 2011

Last updated

Jun 27, 2011By 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

Ms. Angela Sue Martin, MBA

Title

Office Manager

Phone

(214) 526-8100

Specialties & licenses 1

Addresses

Other names 1

• Oak Lawn Dermatology Doing business as

Locations

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

{
    "created_epoch": "1294185600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309132800000",
    "number": "1184928194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 OAK LAWN AVE.",
            "address_2": "SUITE 650",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752194308",
            "telephone_number": "214-526-8100",
            "fax_number": "214-526-8105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 OAK LAWN AVE",
            "address_2": "SUITE 650",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752194308",
            "telephone_number": "214-526-8100",
            "fax_number": "214-526-8105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN L PROFFITT MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-05",
        "last_updated": "2011-06-27",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "214-526-8100",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Oak Lawn Dermatology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dermatology Physician in Dallas, TX
• Providers in Dallas, TX by specialty
• Dermatology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.