ASC OF BAUCOM & MINA DERM SURGERY JOHNS CREEK LLC
NPI 1013601517
Clinic/Center - Ambulatory Surgical in Johns Creek, GA

Active since June 07, 2023
10750 MEDLOCK BRIDGE RD STE 102, JOHNS CREEK, GA 30097(470) 545-2124(404) 844-0499 Get Directions Write a Review

NPPES record last updated: December 13, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Dec 13, 2023, Jun 7, 2023 (2 updates tracked since 2023).

  • Organization
  • Clinic/Center
  • Ambulatory Surgical

About ASC OF BAUCOM & MINA DERM SURGERY JOHNS CREEK LLC

This page provides the complete NPI Profile along with additional information for Asc Of Baucom & Mina Derm Surgery Johns Creek Llc, a provider established in Johns Creek, Georgia operating as a Clinic/center, focusing in ambulatory surgical . The healthcare provider is registered in the NPI registry with number 1013601517 assigned on June 2023. The practitioner's primary taxonomy code is 261QA1903X. The provider is registered as an organization and their NPI record was last updated 3 years ago. The authorized official of this NPI record is Mark F Baucom Md (Owner)

NPI
1013601517 Verify this NPI
Provider Name
ASC OF BAUCOM & MINA DERM SURGERY JOHNS CREEK LLC
Entity Type
Organization
Location Address
10750 MEDLOCK BRIDGE RD STE 102 JOHNS CREEK, GA 30097
Location Phone
(470) 545-2124
Location Fax
(404) 844-0499
Mailing Address
5555 PEACHTREE DUNWOODY RD STE 206 ATLANTA, GA 30342
Mailing Phone
(404) 844-0496
Mailing Fax
(404) 844-0499
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
06-07-2023
Last Update Date
12-13-2023
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center Ambulatory Surgical

Taxonomy Code
261QA1903X
Type
Ambulatory Health Care Facilities

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MARK F BAUCOM MD

Authorized Official Title
OWNER
Authorized Official Phone
(404) 844-0496

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm

This procedure involves the complex repair of a wound in areas like the forehead, cheeks, chin, mouth, neck, underarms, hands, or feet. The wound size ranges from 2.6-7.5 cm. The process includes cleaning, removing damaged tissue, and stitching the wound for proper healing.

This service was performed 13 times for 12 patients

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Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1013601517, enumerated as an "organization" on June 07, 2023.

The provider is located at 10750 MEDLOCK BRIDGE RD STE 102 JOHNS CREEK, GA 30097 and the phone number is (470) 545-2124.

Clinic/Center with taxonomy code 261QA1903X and a focus in Ambulatory Surgical.