DR. ANGELA BOOTH WINGFIELD (NPI# 1962494294) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1962494294 |
Entity Type | Individual |
Full Name | DR. ANGELA BOOTH WINGFIELD |
Credential | MD |
Practice Address |
11295 E Taylor Rd Gulfport MS 39503-4197 |
Practice Telephone | 2288643300 |
Mailing Telephone | 2288643300 |
Enumeration Date | 2005-08-23 |
Last Update Date | 2020-05-06 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207NS0135X |
Dermatology Specialization: Procedural Dermatology |
024878 | LA | Allopathic & Osteopathic Physicians |
Y | 207NS0135X |
Dermatology Specialization: Procedural Dermatology |
1731 | MS | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
CLIA | 25D1013637 | 01 | |
MS | 00874879 | 05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1598826232 | Angela Wingfield | Case Manager/Care Coordinator | 2110 Fairburn Rd Ste B, Douglasville, GA 30135-1090 | 2006-12-13 |
Street Address |
11295 E TAYLOR RD |
City | GULFPORT |
State | MS |
Zip Code | 39503-4197 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1740533280 | Barbra Ellen Jablanski | Physician Assistant | 11295 E Taylor Rd, Gulfport, MS 39503 | 2012-10-22 |
1508143546 | Emily Anne Burger | Physician Assistant | 11295 E Taylor Rd, Gulfport, MS 39503-4197 | 2011-11-04 |
1245567775 | Kassie Stafford | Physician Assistant | 11295 E Taylor Rd, Gulfport, MS 39503-4197 | 2009-11-04 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1013515451 | Gulf Coast Neurospa, LLC | Psychiatry & Neurology | 8845 Lorraine Road, Gulfport, MS 39503 | 2020-10-16 |
1447865985 | Nicholas Wyrosdick | Physical Therapist | 12261 Us 49 #1, Gulfport, MS 39503 | 2020-09-11 |
1750935169 | Ladner Roy Drugs, LLC. | Pharmacy | 12261 Us 49 Suite 16, Gulfport, MS 39503 | 2019-07-25 |
1528559440 | Alexander Therapy Services, LLC | Clinic/Center | 15465 Oak Ln Ste 100c, Gulfport, MS 39503 | 2018-05-25 |
1750879003 | Heather Lynn Theisen | Nurse Practitioner | 15190 Community Rd Ste 330, Gulfport, MS 39503 | 2018-04-23 |
1083101216 | Gulf Coast Mental Health Center | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 15094 County Barn Road, Gulfport, MS 39503 | 2018-04-13 |
1306343173 | Dr. Raymond Monsour Scurfield, LLC | Community/Behavioral Health | 15465 Oak Lane Ste 100-g, Gulfport, MS 39503 | 2018-04-09 |
1952817157 | Mary Beth Welch | Behavioral Analyst | 9230 Old Lorraine Rd, Gulfport, MS 39503 | 2017-12-26 |
1831603257 | Beach View Family Dental, Pllc | Dentist | 9072 Lorraine Road, Gulfport, MS 39503 | 2017-11-21 |
1437677721 | Mary Stephens Ruffin | Social Worker | 11262 Creek Dr, Gulfport, MS 39503 | 2017-09-07 |
Find all providers in zip 39503 |
Taxonomy Code | 207NS0135X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Dermatology |
Specialization | Procedural Dermatology |
Procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers). |
Notes: Source: American Board of Dermatology, 2007, www.abderm.org [1/1/2008: definition added, source added, title changed] Additional Resources: Some ABMS board certified dermatologists have completed a one-year ACGME approved fellowship in Procedural Dermatology, which has been offered since 2003. At this time the ABD does not offer subspecialty certification in Procedural Dermatology. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1487843199 | The Cutaneous Laser Center | Dermatology | 501 Marshall St Ste 606, Jackson, MS 39202-1650 | 2007-10-18 |
1104980416 | Larry E Millikan | Dermatology | 2321 13th St, Meridian, MS 39301-3940 | 2006-12-21 |
1932176641 | Sabra Sullivan | Dermatology | 501 Marshall St, Suite 606, Jackson, MS 39202-1651 | 2006-03-01 |
Please comment or provide details below to improve the information on DR. ANGELA BOOTH WINGFIELD.
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.