Dermatology & Skin Cancer Specialists, LLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

MD02411R Issued in LA

Legal business name

DERMATOLOGY & SKIN CANCER SPECIALISTS, LLC

Practice address

9314 Normandie Dr
Shreveport, LA 71118-3866

Phone

(318) 686-2021

Fax

(318) 688-6329

NPI assigned

Jan 17, 2007

Last updated

Jun 5, 2013By the provider in NPPES

Organization subpart

Yes

Parent organization

DERMATOLOGY & SKIN CANCER SPECIALISTS, LLCAs reported in NPPES

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

Authorized official

Name

Carol R Wadsworth

Title

Office Manager

Phone

(318) 686-2021

Specialties & licenses 1

Addresses

Part of

Derm Skin Cancer Specialis

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• George Michael Kent, M.D.

  • Dermatology Physician
  • Bossier City, LA
  • NPI 1144333857
  NPD (past)

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370390400000",
    "number": "1699827113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 17607",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711380607",
            "telephone_number": "318-686-2021",
            "fax_number": "318-688-6329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9314 NORMANDIE DR",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711183866",
            "telephone_number": "318-686-2021",
            "fax_number": "318-688-6329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY & SKIN CANCER SPECIALISTS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DERMATOLOGY & SKIN CANCER SPECIALISTS, LLC",
        "enumeration_date": "2007-01-17",
        "last_updated": "2013-06-05",
        "status": "A",
        "authorized_official_last_name": "WADSWORTH",
        "authorized_official_first_name": "CAROL",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "318-686-2021"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "LA",
            "license": "MD02411R",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Department of Health & Hospitals (Shreveport Behavioral Health Clinic - Child & Adolescent)
• Department of Health and Hospitals (Pines Treatment Center)
• Department of Health and Hospitals
• Dependable Care Services
• Allison Louise Derise, MD
• Dermatology and Skin Surgery Apmc
• Alyssa Derouen
• Jennifer Derrick
• Kristy Derrick, MS,RD,LD,CNSC
• Evelyn Derry, PH.D.

• Specialist in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Specialist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2013; 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.