ASC OF BAUCOM & MINA DERM SURGERY – NPI #1356429765
Clinic/Center

ASC OF BAUCOM & MINA DERM SURGERY is an AHC clinic located in ATLANTA, GA. NPPES has assigned the NPI number 1356429765 to ASC OF BAUCOM & MINA DERM SURGERY on November 02, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “ASC OF BAUCOM & MINA DERM SURGERY” is a dba name, the actual legal business name for this organization is ASC OF GEORGIA DERMATOLOGIC SURGERY. The primary taxonomy selected by this provider is 261QA1903X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Ambulatory Surgical

The NPI profile was previously updated about 2 years ago on Dec 13, 2023. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for ASC OF BAUCOM & MINA DERM SURGERY below.

NPI Profile for
ASC OF GEORGIA DERMATOLOGIC SURGERY

NPI Number
1356429765
Enumeration Date

(more than 19 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
ASC OF GEORGIA DERMATOLOGIC SURGERY
Doing Business As (dba): ASC OF BAUCOM & MINA DERM SURGERY
Primary location
5555 PEACHTREE DUNWOODY RD STE 220
ATLANTA, GA 30342-1724
Phone: (404) 844-0496 Fax: (404) 844-0499
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
MARK BAUCOM
PRESIDENT
Phone: (404) 844-0496
Updated
Certification Date
Dec 13, 2023

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QA1903X
- Clinic/Center / Ambulatory Surgical (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.