Dermatology and Dermatology Surgery of Mobile PC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

DERMATOLOGY AND DERMATOLOGY SURGERY OF MOBILE PC

Practice address

3153 Dauphin St
Mobile, AL 36606-4061

Phone

(251) 445-8888

Fax

(251) 479-7164

NPI assigned

Oct 3, 2008

Organization subpart

No

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

Authorized official

Name

Roberta Swain, MD

Title

Owner

Phone

(251) 414-5810

Specialties & licenses 1

Addresses

Other identifiers 3

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

{
    "created_epoch": "1222992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1448323200000",
    "number": "1770734154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3153 DAUPHIN ST",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366064061",
            "telephone_number": "251-445-8888",
            "fax_number": "251-479-7164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3153 DAUPHIN ST",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366064061",
            "telephone_number": "251-445-8888",
            "fax_number": "251-479-7164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY AND DERMATOLOGY SURGERY OF MOBILE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-03",
        "last_updated": "2015-11-24",
        "status": "A",
        "authorized_official_last_name": "SWAIN",
        "authorized_official_first_name": "ROBERTA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "251-414-5810",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "510G70048",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF ALABAMA",
            "identifier": "51594108",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "510G70048",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• 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 24, 2015; 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.