Deep South Dermatology

Primary specialty

SpecialistTaxonomy code 174400000X

License

00018113 Issued in AL

Legal business name

DEEP SOUTH DERMATOLOGY

Practice address

8573 County Road 64
Daphne, AL 36526-8706

Phone

(251) 621-2244

Fax

(251) 621-7209

NPI assigned

Nov 29, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Alan R Stanford, MD

Title

Owner

Phone

(251) 621-2244

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Christin Marie Rowe, P.A.-C.

  • Physician Assistant
  • Fairhope, AL
  • NPI 1730129479
  NPD

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212451200000",
    "number": "1710054556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 40",
            "city": "DAPHNE",
            "state": "AL",
            "postal_code": "365260040",
            "telephone_number": "251-621-2244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8573 COUNTY ROAD 64",
            "city": "DAPHNE",
            "state": "AL",
            "postal_code": "365268706",
            "telephone_number": "251-621-2244",
            "fax_number": "251-621-7209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEEP SOUTH DERMATOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-29",
        "last_updated": "2008-06-03",
        "status": "A",
        "authorized_official_last_name": "STANFORD",
        "authorized_official_first_name": "ALAN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "251-621-2244",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "AL",
            "license": "00018113",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AL BLUE CROSS",
            "identifier": "30930",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Janika Bullock Davis, MS, CCC-SLP
• Leslie B Davis, OTR/L
• Mary Grace Davis
• Cindy Karen Dawkins, OTR
• Daylight Therapy LLC
• Robert Detrinis, M.D.
• Erin Tiberio Di Fate, LCSW PIP
• Diane Zills, LLC
• Krislyn Michelle Dienes, OTR/L
• Dixie Dental Center, P.C.

• Specialist in Daphne, AL
• Providers in Daphne, AL by specialty
• Specialist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2008; 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.