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

Last updated

Jan 5, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Mark Francis Baucom, M.D.NPI 1831184357

Title

President

Phone

(404) 943-1996

Specialties & licenses 1

Addresses

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.

• Mark Francis Baucom, M.D.

  • MOHS-Micrographic Surgery Physician
  • Atlanta, GA
  • NPI 1831184357
  Authorized official Same address or phone

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

{
    "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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• MOHS-Micrographic Surgery Physician in Atlanta, GA
• Providers in Atlanta, GA by specialty
• MOHS-Micrographic Surgery Physician in Georgia

• 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.