ATHENS-OCONEE SKIN CANCER & DERMATOLOGY, LLC
NPI 1790989291
Dermatology - Procedural Dermatology in Watkinsville, GA
- Organization
- Dermatology
- Procedural Dermatology
About ATHENS-OCONEE SKIN CANCER & DERMATOLOGY, LLC
This page provides the complete NPI Profile along with additional information for Athens-oconee Skin Cancer & Dermatology, Llc, a provider established in Watkinsville, Georgia operating as a Dermatology, focusing in procedural dermatology . The healthcare provider is registered in the NPI registry with number 1790989291 assigned on June 2007. The practitioner's primary taxonomy code is 207NS0135X with license number 050931 (GA). The provider is registered as an organization and their NPI record was last updated one year ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Stella Maries Bulengo M.d. (Owner)
- NPI
- 1790989291 Verify this NPI
- Provider Name
- ATHENS-OCONEE SKIN CANCER & DERMATOLOGY, LLC
- Other Name Type
- (6)
- Entity Type
- Organization
- Location Address
- 1582 MARS HILL RD SUITE A WATKINSVILLE, GA 30677
- Location Phone
- (706) 769-7546
- Location Fax
- (706) 769-2443
- Mailing Address
- 1582 MARS HILL RD SUITE A WATKINSVILLE, GA 30677
- Mailing Phone
- (706) 769-7546
- Mailing Fax
- (706) 769-2443
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 06-11-2007
- Last Update Date
- 09-11-2025
- Code Navigator
Location Map
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
Dermatology Procedural Dermatology
- Taxonomy Code
- 207NS0135X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 050931
- License State
- GA
- Taxonomy Description
- 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).
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 207N00000X | Allopathic & Osteopathic Physicians | Dermatology | 050931 (GA) |
| 2 | 207ND0900X | Allopathic & Osteopathic Physicians | Dermatology | 050931 (GA) |
Group Taxonomy 193400000X MULTIPLE 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.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 050931 | OTHER (01) | GA | LICENSE |
| 1194717447 | OTHER (01) | NPI INDIVIDUAL |
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Other Providers at the Same Location
The following 2 providers are registered at the same or a nearby location.
WATKINSVILLE, GA 30677
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1790989291, enumerated as an "organization" on June 11, 2007.
The provider is located at 1582 MARS HILL RD SUITE A WATKINSVILLE, GA 30677 and the phone number is (706) 769-7546.
Dermatology with taxonomy code 207NS0135X and a focus in Procedural Dermatology.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
