JULIE P WYATT (NPI# 1053532226) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1053532226 |
Entity Type | Individual |
Full Name | JULIE P WYATT |
Credential | MD |
Practice Address |
3000 Old Canton Rd Ste 430 Jackson MS 39216 |
Mailing Address |
3000 Old Canton Rd Ste 430 Jackson MS 39216-4225 |
Practice Telephone | 6019825441 |
Practice Fax Number | 6019825442 |
Mailing Telephone | 6019825441 |
Mailing Fax Number | 6018156613 |
Enumeration Date | 2007-05-02 |
Last Update Date | 2018-08-30 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207N00000X | Dermatology | 20645 | MS | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MS | 08655862 | 05 | |
RR MEDICARE | P00781089 | 01 | |
MS | RAILROAD MEDICARE PTAN | P01193355 | 01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1508281502 | Julie Wyatt | Counselor | 65 Monticello Dr, North Attleboro, MA 02760-4300 | 2014-02-27 |
1285158907 | Julie Anna Wyatt | Counselor | 2924 Knight St, Shreveport, LA 71105-2415 | 2017-08-03 |
1932297041 | Julie J Wyatt | Physical Therapist | 3501 Midway Rd, Suite 198, Plano, TX 75093 | 2006-10-11 |
1386740611 | Julie Victoria Wyatt | Nurse Practitioner | 82-68 164th St, Jamaica, NY 11432-1121 | 2006-09-15 |
Street Address |
3000 OLD CANTON RD STE 430 |
City | JACKSON |
State | MS |
Zip Code | 39216 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1982165080 | Amy Heidelberg | Nurse Practitioner | 3000 Old Canton Rd Ste 430, Jackson, MS 39216-4225 | 2019-03-29 |
1114409422 | Julie Wyatt Dermatology Clinic, Pllc | Dermatology | 3000 Old Canton Rd Ste 430, Jackson, MS 39216-4225 | 2018-09-04 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1861011553 | Ashley Melancon Prewitt | Registered Nurse | St. Dominic's North Campus, Behavioral Health, Jackson, MS 39216 | 2020-04-13 |
1194353391 | Brianna Arrington | Student in an Organized Health Care Education/Training Program | Med/ Peds, 2500 N. State St., Jackson, MS 39216 | 2020-04-01 |
1720616485 | Roshina Khalid Khan | Student in an Organized Health Care Education/Training Program | Department of Anesthesiology, Ummc, 2500 N. State St., Jackson, MS 39216 | 2020-03-30 |
1275183550 | Amanda Lynn Morellato | Dentist | Ummc School of Dentistry, 2500 North State Street, Jackson, MS 39216 | 2019-09-18 |
1396305553 | Abhishek Chhabra | Student in an Organized Health Care Education/Training Program | Lakeland Family Medicine Clinic, 878 Lakeland Dr., Jackson, MS 39216 | 2019-06-19 |
1427615996 | Hometown Diagnostics | Clinical Medical Laboratory | Translational Research Center Tr311, 2500 North State Street, Jackson, MS 39216 | 2019-05-21 |
1346807773 | Shukundala C Smith | Behavior Technician | New Learning Resources 2510 Lakeland Terrace, Jackson, MS 39216 | 2019-05-21 |
1063901098 | G Eli Howell Md Pllc | Plastic Surgery | 971 Lakeland Dr Ste 225, Jackson, MS 39216 | 2018-05-04 |
1588168132 | Caleb Zumbro | Student in an Organized Health Care Education/Training Program | Ummc Med/peds, 2500 N. State St., Jackson, MS 39216 | 2018-03-20 |
1639677230 | Walgreen Co | Pharmacy | 971 Lakeland Dr Ste 101, Jackson, MS 39216 | 2018-01-29 |
Find all providers in zip 39216 |
Taxonomy Code | 207N00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Dermatology |
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1427408319 | Advanced Dermatology of Wyoming, Inc | Dermatology | 62 South Redmond Street, Jackson, WY 83001-8664 | 2016-06-21 |
1871814095 | Elizabeth Anne Gordon Spratt | Dermatology | 3333 Spring Arbor Rd Ste 500, Jackson, MI 49203-8605 | 2010-06-22 |
1962644013 | Virginia Anne Koubek | Dermatology | 87 Murray Guard Dr Ste B, Jackson, TN 38305-3775 | 2009-04-02 |
1265653745 | Brittany Wilson Baker | Dermatology | 984 W Broadway, Suite 4, Jackson, WY 83001-0000 | 2007-05-01 |
1982705570 | Louis Julian Wise Jr. | Dermatology | 3000 Old Canton Road, Suite 430, Jackson, MS 39216 | 2006-09-26 |
1215940937 | Sterling Ruffin Craig | Dermatology | 2817 North Highland Avenue, Suite A, Jackson, TN 38305-1789 | 2006-08-14 |
1366459026 | Chemene Quinn | Dermatology | 501 Marshall St Ste 406, Dermatology Consultants, Pllc, Jackson, MS 39202-1650 | 2006-08-02 |
1609893296 | Kenneth R. Maloney | Dermatology | 294 Summar Drive, Jackson, TN 38301 | 2006-07-17 |
1720039423 | William P Teer | Dermatology | 1320 Union University Dr, Jackson, TN 38305-3780 | 2006-05-15 |
1447233754 | Jonathan Glenn Baker | Dermatology | 984 West Broadway, Suite 4, Jackson, WY 83001-0000 | 2005-11-22 |
Find all providers in JACKSON |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.