ARIZONA SKIN AND DERMATOLOGY PC (NPI# 1639569825) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639569825 |
| Entity Type | Organization |
| Organization Name | ARIZONA SKIN AND DERMATOLOGY PC |
| Practice Address |
153 W Central Ave Coolidge AZ 85128-4405 |
| Mailing Address |
8380 W Emile Zola Ave Ste 5116 Peoria AZ 85381-4811 |
| Practice Telephone | 6025294700 |
| Practice Fax Number | 6025294699 |
| Mailing Telephone | 6025294700 |
| Mailing Fax Number | 6025294699 |
| Enumeration Date | 2015-01-27 |
| Last Update Date | 2015-01-27 |
| Authorized Official Name | DR. MANNTEJ SRA (OWNER) |
| Authorized Official Telephone | 6025294700 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | PTAN | Z171303 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558767962 | Arizona Skin and Dermatology PC | Family Medicine | 10249 W Thunderbird Blvd, Suit 100, Sun City, AZ 85351-3113 | 2014-11-12 |
| Street Address |
153 W CENTRAL AVE |
| City | COOLIDGE |
| State | AZ |
| Zip Code | 85128-4405 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629636253 | Terhea A Smith | Physical Therapy Assistant | 2155 W Pima Ave, Coolidge, AZ 85128 | 2019-05-29 |
| 1912310913 | Josette Rossi | Counselor | 556 South Arizona Ave., Pinal Hispanic Council, Coolidge, AZ 85128 | 2014-06-06 |
| 1952745531 | Community Partners Integrated Healthcare, Inc. | Community/Behavioral Health | 120b N Arizona Blvd., Ste. F, Coolidge, AZ 85128 | 2013-04-25 |
| 1346550878 | Laura Grace Lew | Registered Nurse | 800 W. Northern Ave., Coolidge, AZ 85128 | 2010-10-18 |
| 1962682203 | Douglas Santiago | Audiologist | 4713 West Ginger Avenue, Coolidge, AZ 85128 | 2007-11-04 |
| 1528113859 | Pinal County Arizona | Public Health or Welfare | 119 W. Central Avenue, Coolidge, AZ 85128 | 2007-01-25 |
| 1265085567 | The River's Edge Dental | Dentist | 1185 N Arizona Blvd, Coolidge, AZ 85128 | 2019-07-17 |
| 1700291440 | Robin Wilson | Nurse Practitioner | 1284 N Arizona Blvd, Coolidge, AZ 85128 | 2014-06-20 |
| 1407981384 | Max A Almodovar | Dentist | 417 W Central Ave, Ste #a, Coolidge, AZ 85128-0028 | 2007-02-22 |
| 1093805160 | Michael Eugene Wilkinson | Dentist | 1185 N Arizona Blvd, Coolidge, AZ 85128-3203 | 2006-10-12 |
| Find all providers in zip 85128 | ||||
| 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 |
|---|---|---|---|---|
| 1902355720 | Arizona Skin and Laser Therapy Institute, Ltd | Dermatology | 153 N Central Ave, Coolidge, AZ 85128-4405 | 2016-09-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215559471 | Innovative Dermatology Alliance Az, PC | Dermatology | 390 Bralliar Rd, Wickenburg, AZ 85390 | 2020-05-11 |
| 1902427735 | Derma Healthcare Solutions Pllc | Dermatology | 4716 E Thunderbird Rd, Phoenix, AZ 85032-5541 | 2020-05-04 |
| 1598310559 | Avant Dermatology & Aesthetics Pllc | Dermatology | 8580 N Oracle Rd Ste 140, Oro Valley, AZ 85704-6512 | 2019-08-07 |
| 1982268504 | Melody Maarouf | Dermatology | 7165 N Pima Canyon Dr, Tucson, AZ 85718-1407 | 2019-04-29 |
| 1114485646 | Saguaro Dermatology Associates LLC | Dermatology | 3400 E Mcdowell Rd Fl 2, Phoenix, AZ 85008-3884 | 2019-03-04 |
| 1114405503 | Joshua Harrison | Dermatology | 13771 N Fountain Hills Blvd # 114-103, Fountain Hills, AZ 85268-3762 | 2018-07-30 |
| 1386133684 | Az Mobile Derm Inc | Dermatology | 6857 E Beverly Ln, Scottsdale, AZ 85254-1566 | 2018-05-02 |
| 1225533409 | Rcdc of Mesa Plc | Dermatology | 270 W Chandler Heights Rd Ste 4, Chandler, AZ 85248-5084 | 2018-03-28 |
| 1548779713 | Ryan Kirk Bingham | Dermatology | 2855 E Brown Rd Ste 22, Mesa, AZ 85213-4216 | 2017-09-20 |
| 1306369996 | Clear Sky Dermatology LLC | Dermatology | 14044 W Camelback Rd Ste 220, Litchfield Park, AZ 85340-9426 | 2017-07-25 |
| Find all providers with the same taxonomy | ||||
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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.