1. Home
  2. Directory
  3. Arkansas
  4. Russellville
  5. Dermatology
  6. NPI Profile

RUSSELLVILLE DERMATOLOGY CLINIC PA
NPI 1477529436
Dermatology - Procedural Dermatology in Russellville, AR

Active since February 28, 2006
1602 W MAIN ST, RUSSELLVILLE, AR 72801(479) 968-6969(479) 968-4290 Get Directions Write a Review

NPPES record last updated: March 7, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Russellville Dermatology Clinic Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RUSSELLVILLE DERMATOLOGY CLINIC PA (NPI 1477529436) is a healthcare organization registered as a procedural dermatology in Russellville, Arkansas and active in the NPI registry since February 2006. The organization lists William W Galloway, President / Owner, as its authorized official.

NPPES Registry Identity

NPI1477529436
Entity TypeOrganization
Primary Taxonomy207NS0135X
Legal Business NameRUSSELLVILLE DERMATOLOGY CLINIC PA
Location Address1602 W MAIN STRussellville, AR 72801-2720
Mailing AddressPo Box 843Russellville, AR 72811-0843 · (479) 968-6969 · Fax (479) 968-4290
Phone(479) 968-6969
Fax(479) 968-4290
Organization SubpartNo
Authorized OfficialWilliam W GallowayPresident / Owner · (479) 968-6969
Enumeration DateFebruary 28, 2006
Last NPPES UpdateMarch 7, 2023
✔ NPI 1477529436 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatology · Procedural DermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207NS0135X
License✔ Licensed in AR · MC0841
Definition
Procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers).
1602 W MAIN ST, Russellville, AR 72801
Open in Google Maps ↗

Other Identifiers 1

Medicaid110005002AR

Group Practice 1

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

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. WILLIAM W GALLOWAY M.D.
Dermatology (Procedural Dermatology)
1602 W MAIN ST
RUSSELLVILLE, AR 72801
Pope County (479) 968-6969

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Russellville Dermatology Clinic PA's NPI number?

The NPI number for Russellville Dermatology Clinic PA is 1477529436. It was assigned to this organization in the NPPES registry on February 28, 2006.

Where is Russellville Dermatology Clinic PA located?

Russellville Dermatology Clinic PA is located at 1602 W Main St, Russellville, AR 72801. The listed phone number is (479) 968-6969.

What is Russellville Dermatology Clinic PA's specialty?

The primary specialty registered for this NPI is Dermatology, specializing in Procedural Dermatology, with taxonomy code 207NS0135X.

When was this NPI record last updated?

The NPPES record for Russellville Dermatology Clinic PA was last updated on March 7, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.