Georgia Dermatologic Surgery Center, PC

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

Legal business name

GEORGIA DERMATOLOGIC SURGERY CENTER, PC

Practice address

5555 Peachtree Dunwoody Rd NE
Suite G65
Atlanta, GA 30342-1703

Phone

(404) 943-1996

Fax

(404) 943-9464

NPI assigned

Apr 4, 2007

Organization subpart

No

Name

Dr. Mark Francis Baucom, M.D.

Title

President

Phone

(404) 943-1996

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 5, 2012.

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1325721600000",
    "number": "1720100522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5555 PEACHTREE DUNWOODY RD NE",
            "address_2": "SUITE G65",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421703",
            "telephone_number": "404-943-1996",
            "fax_number": "404-943-9464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 PEACHTREE DUNWOODY RD NE",
            "address_2": "SUITE G65",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421703",
            "telephone_number": "404-943-1996",
            "fax_number": "404-943-9464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGIA DERMATOLOGIC SURGERY CENTER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-04",
        "last_updated": "2012-01-05",
        "status": "A",
        "authorized_official_last_name": "BAUCOM",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "FRANCIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "404-943-1996",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2012; 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.