GOLDSBORO SKIN CENTER PA


Address: 2613 Hospital Rd, Goldsboro, NC 27534-9424
Phone: 9197360222

GOLDSBORO SKIN CENTER PA (NPI# 1972567634) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1972567634
Entity Type Organization
Organization Name GOLDSBORO SKIN CENTER PA
Practice Address 2613 Hospital Rd
Goldsboro
NC 27534-9424
Practice Telephone 9197360222
Practice Fax Number 9197360223
Mailing Telephone 9197360222
Mailing Fax Number 9197360223
Enumeration Date 2006-04-12
Last Update Date 2020-08-22
Authorized Official Name DR. JOHN L JENNINGS JR. (PRESIDENT)
Authorized Official Telephone 9197360222
Authorized Official Credential MD
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
X 207NS0135X Dermatology
Specialization: Procedural Dermatology
27212 NC Allopathic & Osteopathic Physicians
X 207ND0900X Dermatology
Specialization: Dermatopathology
27212 NC Allopathic & Osteopathic Physicians
X 207N00000X Dermatology 27212 NC Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
NC 89012KT 05

Office Location

Street Address 2613 HOSPITAL RD
City GOLDSBORO
State NC
Zip Code 27534-9424

Providers in the same location

NPI Name Taxonomy Address Enumeration
1891776753 John L Jennings Jr. Dermatology 2613 Hospital Rd, Goldsboro, NC 27534 2005-11-08
1326532169 Forefront Dermatology, S.c. Dermatology 2613 Hospital Rd, Goldsboro, NC 27534 2018-06-15
1659510279 Erica Willis Johnson Physician Assistant 2613 Hospital Rd, Goldsboro, NC 27534 2009-02-05
1912977059 Brooke Worley Jones Physician Assistant 2613 Hospital Rd, Goldsboro, NC 27534 2006-01-23
1669455010 Albert L Bridger Physician Assistant 2613 Hospital Rd, Goldsboro, NC 27534 2005-11-21

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1457875767 Trent Jonathan Forshey Physical Therapist 2126 Wayne Memorial Dr, Goldsboro, NC 27534 2017-07-28
1336685551 Wayne Al Holdings, LLC Assisted Living Facility 901 West New Hope Rd, Goldsboro, NC 27534 2017-01-11
1952845471 Latoya Faulk Social Worker 121 Carolina Forest Drive, Goldsboro, NC 27534 2016-12-19
1528415841 Kelby Joseph Sage Durnin Military Health Care Provider 1020 Jabara Avenue, Seymour Johnson Afb, NC 27534 2016-05-17
1528490604 Eric Christian Bourgeois Physical Therapist 1101a Gracie Pl, Goldsboro, NC 27534 2013-07-31
1831439165 Erica Nicole Davis Optometrist 20/20 Vision Center 625 North Berkeley Blvd, Suite D, Goldsboro, NC 27534 2013-02-23
1891039236 Betty Webb Zimmerman Nurse Practitioner 204 Cox Blvd, Goldsboro, NC 27534 2012-11-26
1144595265 Life Recovery Psychological Services Counselor 1202-c Wayne Memorial Dr, Goldsboro, NC 27534 2012-03-22
1558596536 Taylor Home Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 802 Taylor St, Goldsboro, NC 27534 2009-05-20
1780895136 Sherrie Fennell Edwards Dietitian, Registered 1500 Lanely Ave., Seymour Johnson Afb, Golsboro, NC 27534 2007-05-25
Find all providers in zip 27534

Taxonomy Information

Taxonomy Code 207NS0135X
Grouping Allopathic & Osteopathic Physicians
Classification Dermatology
Specialization Procedural Dermatology

Taxonomy Definition

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.

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1740747187 Joyce E. Carter Dermatology 1404 Hope Mills Rd, Fayetteville, NC 28304-4219 2019-02-21
1538359708 Richard H Shereff Md Pa Dermatology 139 Hunter Circle, Fayetteville, NC 28304-3408 2007-07-25
1508183286 Christopher Ryan Urban Dermatology 78 Long Shoals Rd, Arden, NC 28704-7782 2010-04-21
1508988742 Jennifer Marie Defazio Dermatology 517 Moye Blvd Fl 3, Ecu Physicians Dermatology, Moye Medical #2, Greenville, NC 27834-2849 2007-04-06
1497815328 Wake Dermatology Associates, Pa Dermatology 4414 Lake Boone Trl, Ste 408, Raleigh, NC 27607-7513 2006-12-11
1962593509 Deborah Kessler Hudak Dermatology 8311 Bandford Way, Suite 103, Raleigh, NC 27615-2756 2006-09-27
1871579110 William T Sumner Dermatology 335 Penny Ln, Concord, NC 28025-1221 2005-12-19
1477539724 Maryanna C Ter Poorten Dermatology 335 Penny Ln, Concord, NC 28025-1221 2005-12-19
1265426571 Carol Catherine Lekan Dermatology 10931 Raven Ridge Rd, Ste 101, Raleigh, NC 27614-6499 2005-09-01

Competitor

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City GOLDSBORO
Zip Code 27534

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Dataset Information

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.

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