THE DERMATOLOGY CLINIC, PLLC – NPI #1720284946
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.

THE DERMATOLOGY CLINIC, PLLC is a dermatologist located in GULFPORT, MS. NPPES has assigned the NPI number 1720284946 to THE DERMATOLOGY CLINIC, PLLC on June 25, 2007. It is a Type-2 NPI, indicating this NPI number is associated with an organization. According to the NPI Registry, there are 3 additional location(s) assigned to this provider which are listed below. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 207N00000X from the Health Care Provider Taxonomy code set, which is classified as Dermatology.

The NPI profile was last updated on Oct 22, 2024. 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 THE DERMATOLOGY CLINIC, PLLC below.

NPI Profile for
THE DERMATOLOGY CLINIC, PLLC

NPI Number
1720284946
Enumeration Date

(about 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
THE DERMATOLOGY CLINIC, PLLC
Primary location
11295 EAST TAYLOR ROAD
GULFPORT, MS 39503
Phone: (228) 864-3300 Fax: (228) 864-3333
3 Other location(s):
3109 Shortcut Rd
Pascagoula, MS 39567-1811
Phone: (228) 864-3300
Fax: (228) 864-3333
116 Menge Ave
Pass Christian, MS 39571-4736
Phone: (228) 586-9565
Fax: (228) 864-3333
703 Frontage Dr E
Wiggins, MS 39577-8362
Phone: (601) 385-8106
Fax: (228) 864-3333
Mailing address
P.O. BOX 6625
GULFPORT, MS 39506-6625
Phone: (228) 864-3300 Fax: (228) 864-3333
Organization Subpart
No
Authorized Official
ANGELA WINGFIELD
OWNER/PHYSICIAN
Phone: (228) 864-3300
Updated
Certification Date
Oct 18, 2024

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.

Identifiers

Identifiers for THE DERMATOLOGY CLINIC, PLLC

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
otherCLIA25D1013637
medicaidMS06375287
medicaidMS00874879
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
207N00000X
- Dermatology (Primary)
174400000X
- Specialist
TX 17831

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.