DERMATOLOGY & SKIN CANCER CENTER PLLC (NPI# 1285245423) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285245423 |
| Entity Type | Organization |
| Organization Name | DERMATOLOGY & SKIN CANCER CENTER PLLC |
| Practice Address |
4612 29th Ave Meridian MS 39305-1652 |
| Mailing Address |
Po Box 722393 Norman OK 73070-8810 |
| Practice Telephone | 6015120431 |
| Practice Fax Number | 6014825065 |
| Mailing Telephone | 6015120431 |
| Mailing Fax Number | 6014825065 |
| Enumeration Date | 2020-08-12 |
| Last Update Date | 2020-10-14 |
| Authorized Official Name | EMILY K MATTHEWS (OWNER) |
| Authorized Official Telephone | 6015120431 |
| Authorized Official Credential | DO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians |
| Street Address |
4612 29TH AVE |
| City | MERIDIAN |
| State | MS |
| Zip Code | 39305-1652 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013054667 | Dermatology Center of Meridian Pa | Dermatology | 4612 29th Ave, Meridian, MS 39305-1652 | 2007-01-31 |
| 1598374258 | Dermatology and Skin Cancer Center Pllc | Dermatology | 4612 29th Ave, Meridian, MS 39305-1652 | 2020-07-29 |
| 1639407331 | Emily Kate Matthews | Dermatology | 4612 29th Ave, Meridian, MS 39305-1652 | 2009-11-18 |
| 1689711236 | Neill C Porter | Dermatology | 4612 29th Ave, Meridian, MS 39305-1652 | 2007-01-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013521053 | Shirley Home Care, LLC | Nurse's Aide | 4525 Poplar Springs Drive, Meridian, MS 39305 | 2020-09-08 |
| 1871017855 | Robbyn Lee | Nurse Practitioner | 4715 24th Place, Meridian, MS 39305 | 2017-08-01 |
| 1245686575 | Synergy Physical Therapy & Sports Medicine, LLC | Clinic/Center | 2447 47th Court, Suite F, Meridian, MS 39305 | 2016-05-05 |
| 1912305988 | Anderson Regional Medical Center | Family Medicine | 6694 Poplar Springs Drive, Meridian, MS 39305 | 2014-12-08 |
| 1861817603 | Meadowbrook Health & Rehab LLC | Skilled Nursing Facility | 211 Windmill Drive, Meridian, MS 39305 | 2014-03-04 |
| 1982042198 | Kennerh Provine Collins | Pharmacist | 2917 56th Court, Meridian, MS 39305 | 2013-06-10 |
| 1306284880 | A1 In Home Therapy | Community Health Worker | 211 North Hills Street J6, A1 In Home Therapy, Meridian, MS 39305 | 2013-06-06 |
| 1497192876 | Taylor Farland | Dentist | 2300 North Hills, Meridian, MS 39305 | 2013-05-27 |
| 1376814533 | Priscilla Miller | Nurse Practitioner | 4715 42nd Place, Meridian, MS 39305 | 2012-01-19 |
| 1497083927 | Kelley C Gowdy | Nurse Practitioner | 4711 Poplar Springs Drive, Meridian, MS 39305 | 2009-11-20 |
| Find all providers in zip 39305 | ||||
| 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 |
|---|---|---|---|---|
| 1427460849 | Anna Allred Wile | Dermatology | 4331 Highway 39 N Ste A, Meridian, MS 39301-1007 | 2014-05-21 |
| 1265795660 | Richard Scott Thomas | Dermatology | 4664 N Penngrove Way Ste 100, Meridian, ID 83646-7442 | 2012-06-20 |
| 1295022861 | Kenneth Daniel Saul | Dermatology | 5002 Highway 39 N Bldg A, Meridian, MS 39301-1078 | 2011-07-05 |
| 1871798447 | Lawrence Benjamin Mceachin | Dermatology | 3827 Grandview Ave, Meridian, MS 39305 | 2007-06-15 |
| 1831229871 | Alisa Funke | Dermatology | 1618 Millennium Way, Suite 100, Meridian, ID 83642-6457 | 2007-03-07 |
| 1013054667 | Dermatology Center of Meridian Pa | Dermatology | 4612 29th Ave, Meridian, MS 39305-1652 | 2007-01-31 |
| 1972653566 | Naomi Beth Brooks | Dermatology | 3109 S Meridian Rd, Meridian, ID 83642-7088 | 2007-01-12 |
| 1598374258 | Dermatology and Skin Cancer Center Pllc | Dermatology | 4612 29th Ave, Meridian, MS 39305-1652 | 2020-07-29 |
| 1417495615 | Boise Dermatology | Dermatology | 3109 S Meridian Rd, Meridian, ID 83642-7088 | 2017-02-07 |
| 1659827665 | Mountain Pine Dermatology, Pllc | Dermatology | 4664 N Penngrove Way Ste 100, Meridian, ID 83646-7442 | 2016-08-30 |
| Find all providers in MERIDIAN | ||||
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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.