Live Oak Dermatology

NPI #1194209163 in Roswell, Georgia

Provider Information

NPI Number: 1194209163
Entity Type: Organization
Organization Name: Live Oak Dermatology
Primary Specialty: Dermatology
Enumeration Date: Sep 17, 2018
Last Updated: Jul 22, 2022

Practice Location

Address: 135 NORCROSS ST # 8
City: Roswell
State: Georgia
ZIP Code: 30075-3867
Phone: (678) 870-2020

Authorized Official

Name: BRENT GOEDJEN, MD
Title: CEO
Phone: (678) 870-2020

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dermatology	207N00000X	Primary

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