Tri-State Dermatology & Skin Care, LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

01044950A Issued in IN

Legal business name

TRI-STATE DERMATOLOGY & SKIN CARE, LLC

Practice address

7516 Eagle Crest Blvd
Suite D
Evansville, IN 47715-9142

Phone

(812) 842-0305

Fax

(812) 842-0305

NPI assigned

Jun 15, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Naji H. Tawfik, MEDICAL DOCTOR

Title

Owner

Phone

(812) 842-0305

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1245024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245024000000",
    "number": "1447487608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7516 EAGLE CREST BLVD",
            "address_2": "SUITE D",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477159142",
            "telephone_number": "812-842-0305",
            "fax_number": "812-842-0305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7516 EAGLE CREST BLVD",
            "address_2": "SUITE D",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477159142",
            "telephone_number": "812-842-0305",
            "fax_number": "812-842-0305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI-STATE DERMATOLOGY & SKIN CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-15",
        "last_updated": "2009-06-15",
        "status": "A",
        "authorized_official_last_name": "TAWFIK",
        "authorized_official_first_name": "NAJI",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "812-842-0305",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MEDICAL DOCTOR"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "IN",
            "license": "01044950A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dermatology Physician in Evansville, IN
• Providers in Evansville, IN by specialty
• Dermatology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2009; 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.