DERMATOPATHOLOGY SPECIALISTS JIM PHILLIPS MD DERMATOPATHOLOGIST LLC NPI 1003009390

Dermatology (Dermatopathology) in Mt Pleasant, SC

About DERMATOPATHOLOGY SPECIALISTS JIM PHILLIPS MD DERMATOPATHOLOGIST LLC

Dermatopathology Specialists Jim Phillips Md Dermatopathologist Llc is a provider in Mt Pleasant, SC. The NPI number assigned to this provider is 1003009390. The practitioner's primary taxonomy code is Dermatology (207ND0900X). The provider is registered as an organization and their NPI record was last updated 9 years ago. Dermatopathology Specialists Jim Phillips Md Dermatopathologist Llc operates as a single speciality business group with one or more individual providers who practice the same area of specialization.

NPI1003009390 Additional informationCallout TooltipNational Provider Indentifier (NPI)
The 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.
Provider NameDERMATOPATHOLOGY SPECIALISTS JIM PHILLIPS MD DERMATOPATHOLOGIST LLC
Provider Location Address1280 JOHNNIE DODDS BLVD SUITE 101 MT PLEASANT, SC 29464 Additional informationCallout TooltipProvider location address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Mailing AddressPO BOX 30309 CHARLESTON, SC 29417 Additional informationCallout TooltipProvider mailing address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.
NPI Entity TypeOrganization Additional informationCallout TooltipEntity type code
The code describing the type of health care provider that is being assigned an NPI.
Codes are:
1 = (Person): individual human being who furnishes health care;
2 = (Non-person): entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO).
Is Sole Proprietor?N/A
Is Organization Subpart?No Additional informationCallout TooltipWhat is a subpart?
Subparts are the components and separate physical locations of organization health care providers. Examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.
Enumeration Date08-21-2007 Additional informationCallout TooltipProvider enumeration date
The date the provider was assigned a unique identifier (assigned an NPI)
Last Update Date03-23-2009 Additional informationCallout TooltipLast update date
The date that a record was last updated or changed.

Business Address

DERMATOPATHOLOGY SPECIALISTS JIM PHILLIPS MD DERMATOPATHOLOGIST LLC
1280 JOHNNIE DODDS BLVD
SUITE 101
MT PLEASANT, SC
ZIP 29464
Phone: (843) 375-0055
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Mailing Address

DERMATOPATHOLOGY SPECIALISTS JIM PHILLIPS MD DERMATOPATHOLOGIST LLC
PO BOX 30309
CHARLESTON, SC
ZIP 29417
Phone: (843) 554-9300
Fax: (843) 566-8780

Primary Taxonomy

Taxonomy Code207ND0900X Additional informationCallout TooltipPrimary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
ClassificationDermatology
TypeAllopathic & Osteopathic Physicians
SpecializationDermatopathology
License No.8871
License StateSC
Taxonomy DescriptionA dermatopathologist has the expertise to diagnose and monitor diseases of the skin including infectious, immunologic, degenerative and neoplastic diseases. This entails the examination and interpretation of specially prepared tissue sections, cellular scrapings and smears of skin lesions by means of routine and special (electron and fluorescent) microscopes.

Authorized Official

Authorized Official NameDR. JAMES H. PHILLIPS MD Additional informationCallout TooltipAuthorized official name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.
Authorized Official TitleOWNER
Authorized Official Phone(843) 375-0055

193400000X SINGLE SPECIALTY GROUP - This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
GP4721MEDICAID (05)SC
8849MEDICARE PIN (08)SC
DG5570MEDICARE PIN (08)SC

Map Location


DERMATOPATHOLOGY SPECIALISTS JIM PHILLIPS MD DERMATOPATHOLOGIST LLC address is 1280 JOHNNIE DODDS BLVD SUITE 101 MT PLEASANT, SC 29464

Other Providers at the same location


The following 3 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1043241110UNIVERSITY MEDICAL ASSOCIATES
Organization
Clinic/Center (Multi-Specialty)1280 JOHNNIE DODDS BLVD
MT PLEASANT, SC 29464
(843) 792-1414
1659345643 JENNIFER NELSON MAZUR PHARMD
Individual
Pharmacist1280 JOHNNIE DODDS BLVD SUITE 105
MOUNT PLEASANT, SC 29464
(843) 971-1046
1972570372DR. JAMES HARRISON PHILLIPS MD
Individual
Pathology (Dermatopathology)1280 JOHNNIE DODDS BLVD SUITE 104
MT PLEASANT, SC 29464
(843) 284-4799