OrganizationActive
Advanced Dermatology of Georgia, LLC
NPI 1184005068 · Dermatology Physician · Albany, GA
Provider details
- NPI number
- 1184005068
- Entity type
- Organization
- Primary specialty
- Dermatology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Amy Declue, Director of Provider Services(407) 875-2080
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
401 W 4th Ave
Albany, GA 31701-1915
Phone: (229) 883-1130
Fax: (229) 883-1153
Approximate (ZIP-level) locationGet directions
Mailing address
151 Southhall Ln
Maitland, FL 32751-7176
Registry dates
- Enumerated
- 2015-06-16
- Last updated
- 2018-01-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.