Tara Dermatology Center PC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

Legal business name

TARA DERMATOLOGY CENTER PC

Practice address

191 Medical Blvd
Stockbridge, GA 30281-5083

Phone

(770) 991-1000

NPI assigned

Mar 26, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Vincent Peng

Title

Physician

Phone

(770) 991-1000

Specialties & licenses 1

Addresses

Other names 1

• Vincent T Peng MD PC Former legal business name

Locations

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364256000000",
    "number": "1699892380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "191 MEDICAL BLVD",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302815083",
            "telephone_number": "770-991-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "191 MEDICAL BLVD",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302815083",
            "telephone_number": "770-991-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TARA DERMATOLOGY CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-26",
        "last_updated": "2013-03-26",
        "status": "A",
        "authorized_official_last_name": "PENG",
        "authorized_official_first_name": "VINCENT",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "770-991-1000",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vincent T Peng MD PC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Albert Teiko Tagoe, M.D.
• Asif N Tahir, MD
• John Theodore Tallent, SLP
• John Talley
• Cathy Fleurette Tankoua
• Tarsem L. Gupta, MD, PC
• Elizabeth Ayani Tarver
• Monica Tarver, LAPC
• Briana Nicole Tate-York, CAA
• Devesea Tatum, LCSW

• Medical Specialty Clinic/Center in Stockbridge, GA
• Providers in Stockbridge, GA by specialty
• Medical Specialty Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 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.