OrganizationActive
Colquitt Regional Dermatology, LLC
NPI 1649683897 · Dermatology Physician · Moultrie, GA
Provider details
- NPI number
- 1649683897
- Entity type
- Organization
- Primary specialty
- Dermatology PhysicianAllopathic & Osteopathic Physicians
- Parent organization
- Colquitt Regional Medical, Inc
- Organization subpart
- Yes
- Authorized official
- Amanda Roberts, Provider Enrollment Coordinator(229) 891-9131
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
760 26th Ave Se
Moultrie, GA 31768-6799
Phone: (229) 502-9710
Approximate (ZIP-level) locationGet directions
Mailing address
760 26th Ave Se
Moultrie, GA 31768-6799
Registry dates
- Enumerated
- 2014-06-05
- Last updated
- 2022-07-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.