NPIMap

Organization Active NPI

Skin Cancer & Cosmetic Dermatology Center

  • Dermatology Physician
  • Angola, IN
National Provider Identifier
1871995324
Registry record updated Sep 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
01074279A Issued in IN
Legal business name
SKIN CANCER & COSMETIC DERMATOLOGY CENTER
Practice address
306 E Maumee St
Suite 301 - Cameron Medical Office Building
Angola, IN 46703-2038
Phone
(269) 660-1670
Fax
(269) 660-0666
NPI assigned
Sep 16, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2014

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

Authorized official

Name
Dr. Donn Alan Latour, M.D.
Title
Owner
Phone
26966016710

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X 01074279A IN Primary

Addresses

Primary practice location

306 E Maumee St
Suite 301 - Cameron Medical Office Building
Angola, IN 46703-2038

Mailing address

7070 E Drive North
C/O DSSC
Battle Creek, MI 49014
Phone (269) 660-1670

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1410825600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410825600000",
    "number": "1871995324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7070 E DRIVE NORTH",
            "address_2": "C/O DSSC",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "49014",
            "telephone_number": "269-660-1670",
            "fax_number": "269-660-0666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 E MAUMEE ST",
            "address_2": "SUITE 301 - CAMERON MEDICAL OFFICE BUILDING",
            "city": "ANGOLA",
            "state": "IN",
            "postal_code": "467032038",
            "telephone_number": "269-660-1670",
            "fax_number": "269-660-0666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKIN CANCER & COSMETIC DERMATOLOGY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-16",
        "last_updated": "2014-09-16",
        "status": "A",
        "authorized_official_last_name": "LATOUR",
        "authorized_official_first_name": "DONN",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "26966016710",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "IN",
            "license": "01074279A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Angola, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2014; 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.