AT HOME DERMATOLOGY (NPI# 1427543289) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427543289 |
| Entity Type | Organization |
| Organization Name | AT HOME DERMATOLOGY |
| Practice Address |
2816 Lamond Hill Ave Edmond OK 73034-6978 |
| Practice Telephone | 4056948003 |
| Mailing Telephone | 4056948003 |
| Enumeration Date | 2018-06-25 |
| Last Update Date | 2018-06-25 |
| Authorized Official Name | DR. ERIC WYATT (OWNER) |
| Authorized Official Telephone | 4056948003 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | 19537 | OK | Allopathic & Osteopathic Physicians |
| Street Address |
2816 LAMOND HILL AVE |
| City | EDMOND |
| State | OK |
| Zip Code | 73034-6978 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306447172 | Saints Medical Group, LLC | Family Medicine | 2749 Progressive Dr, Suite B, Edmond, OK 73034 | 2020-11-06 |
| 1194339861 | Susan Haesook Kim | Pharmacist | 1400 2nd St, Edmod, Edmond, OK 73034 | 2020-09-01 |
| 1821616038 | Aaron Michael Gowens | Specialist/Technologist | 015 Wantland Hall 100 University Dr., Edmond, OK 73034 | 2020-07-14 |
| 1043834849 | Paddington Place Lcc | Intermediate Care Facility, Mental Illness | 3225 French Park Drive, Suite 6, Edmond, OK 73034 | 2020-06-08 |
| 1083254932 | Purpose Healthcare Inc | Psychologist | 301 South Blvd, Suite 117, Edmond, OK 73034 | 2020-01-08 |
| 1740773662 | Healthcare Express, LLP | Family Medicine | 2300 E 2nd St, Edmond, OK 73034 | 2018-06-14 |
| 1427555713 | Sara Nicole Smith | Specialist/Technologist | 100 N University Drive, Attn: Athletic Training Room, Edmond, OK 73034 | 2018-04-12 |
| 1619475084 | Carissa Leigh Brackelsberg | Chiropractor | 3709 E 2nd St, Edmond, OK 73034 | 2018-01-31 |
| 1760996177 | Laurel Michelle Glendening | Physical Therapist | 3531 River Wood Lane, Edmond, OK 73034 | 2017-11-21 |
| 1134643380 | Keith S Quinn | Dentist | 3008 Peaceful Ln, Edmond, OK 73034 | 2017-07-31 |
| Find all providers in zip 73034 | ||||
| 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 |
|---|---|---|---|---|
| 1174843296 | Todd Mollet | Dermatology | 2017 W I 35 Frontage Rd Ste 270, Edmond, OK 73013-8562 | 2010-06-11 |
| 1790788586 | Michael D John | Dermatology | 620 W 15th St, Edmond, OK 73013-3617 | 2005-05-24 |
| 1336767383 | Southern Plains Medical Center Inc | Dermatology | 9 N Bryant Ave, Edmond, OK 73034-6307 | 2020-07-07 |
| 1124592738 | Andrew John, Md, Pllc | Dermatology | 620 W 15th St, Edmond, OK 73013-3617 | 2019-01-16 |
| 1609193614 | Andrew Riley John | Dermatology | 620 W 15th St, Edmond, OK 73013-3617 | 2010-04-29 |
| 1912043019 | Michael D John Md PC | Dermatology | 620 W 15th St, Edmond, OK 73013-3617 | 2007-01-29 |
| 1528097904 | Hillary Seth Lawrence | Dermatology | 1616 S Kelly Ave, Edmond, OK 73013-3651 | 2006-06-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205320579 | Leslie Rainbolt | Dermatology | 6821 Nw Grand Blvd, Oklahoma City, OK 73116-5413 | 2018-06-19 |
| 1285138032 | Saints Medical Group, LLC | Dermatology | 1440 N Mustang Road, Mustang, OK 73064-7214 | 2018-03-19 |
| 1871012955 | Ssm Health Care of Oklahoma Inc | Dermatology | 3400 S Douglas Blvd Ste 305, Oklahoma City, OK 73150-1018 | 2017-09-11 |
| 1124543145 | Ross C Hensley M. D., Inc. | Dermatology | 4417 W Gore Blvd Ste 7, Lawton, OK 73505-5978 | 2017-08-10 |
| 1801320106 | Epiphany Dermatology of Oklahoma, LLC | Dermatology | 6717 South Yale Avenue, Suite 101, Tulsa, OK 74136-3318 | 2017-04-13 |
| 1962869313 | Paige Elizabeth Beverly | Dermatology | 13100 N Western Ave Ste 301, Oklahoma City, OK 73114-1432 | 2016-01-15 |
| 1629479258 | Dermatology Associates of Oklahoma LLC | Dermatology | 3111 Azalea Park Dr, Muskogee, OK 74401-2284 | 2014-09-15 |
| 1447667613 | Janelle Marshall Pavlis | Dermatology | 800 W Boise Cir Ste 400, Broken Arrow, OK 74012 | 2014-07-18 |
| 1720325533 | Saints Medical Group, LLC | Dermatology | 9720 Broadway Extension, Oklahoma City, OK 73114 | 2013-01-14 |
| 1770845729 | Saints Medical Group LLC | Dermatology | 13128 N Macarthur Blvd, Oklahoma City, OK 73142-3017 | 2012-06-14 |
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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.