NPI 1144588047 · live from the CMS NPI Registry
Academy Dermatologists Group LLC
Dermatology, Procedural Dermatology in Tucson, AZ. National Provider Identifier 1144588047, active.
NPI record
| NPI | 1144588047 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Dermatology, Procedural Dermatology 207NS0135X |
| Practice location | 6648 E Carondelet Dr, Tucson, AZ 85710 |
| Practice phone | 520-886-8151 |
| Mailing address | 6601 Vaught Ranch Rd Ste 200, Austin, TX 78730 |
| Enumerated | April 27, 2012 |
| Last updated | February 28, 2018 |
| Authorized official | Gheorghe Pusta, Ceo |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dermatology | 207N00000X | RN081679 (AZ) |
| Dermatology, Procedural Dermatology primary | 207NS0135X | 11617 (AZ) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.