Gulf Coast Dermatology & Skin Care Centre PLLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

21520 Issued in AL

Legal business name

GULF COAST DERMATOLOGY & SKIN CARE CENTRE PLLC

Doing business as

Advanced Dermatology & Skin Care Centre

Practice address

580 Providence Park Dr E
Second Floor
Mobile, AL 36695-4614

Phone

(251) 631-3570

Fax

(251) 631-3572

NPI assigned

Sep 15, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Thomas W Bender III, M.D.

Title

M.D.

Phone

(251) 631-3570

Specialties & licenses 1

Addresses

Other names 1

• Advanced Dermatology & Skin Care Centre Doing business as

Locations

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

{
    "created_epoch": "1252972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479340800000",
    "number": "1750614301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "580 PROVIDENCE PARK DR E",
            "address_2": "2ND FLOOR",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366954614",
            "telephone_number": "251-631-3570",
            "fax_number": "251-631-3572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 PROVIDENCE PARK DR E",
            "address_2": "SECOND FLOOR",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366954614",
            "telephone_number": "251-631-3570",
            "fax_number": "251-631-3572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GULF COAST DERMATOLOGY & SKIN CARE CENTRE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-15",
        "last_updated": "2016-11-17",
        "status": "A",
        "authorized_official_last_name": "BENDER III",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "M.D.",
        "authorized_official_telephone_number": "251-631-3570",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "AL",
            "license": "21520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Dermatology & Skin Care Centre",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Fawad Gul, MD
• Ankit Gulati, M.D.
• Rashmi Gulati
• Gulf Coast Dermatology & Skin Care Centre
• Gulf Coast Dermatology & Skin Care Centre PLLC
• Gulf Coast Dermatology & Skin Care Centre PLLC
• Gulf Coast Health and Rehabilitation, LLC
• Gulf Coast Homecare LLC Dba Firstlight Homecare of Mobile Eastern Shor
• Gulf Coast Interventional Spine & Joint Specialists LLC
• Gulf Coast Medicine LLC

• Dermatology Physician in Mobile, AL
• Providers in Mobile, AL by specialty
• Dermatology Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2016; 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.