Unknown Individual – Dermatology Physician, NPI 1902849797

Unknown Individual is a healthcare provider. based in Florence, Alabama. specializing in Dermatology Physician. They hold a License No. 00004055 (AL). The NPI Number for Unknown Individual is 1902849797

Main info

Organization
Inactive
64 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1902849797
Phone
(256) 767-1017
Address
216 MARENGO ST
Deactivation Date
19 December 2024

Doctor Profile

Medical School Name
UNIVERSITY OF ALABAMA SCHOOL OF MEDICINE
Secondary Phone
2567671017
Graduation Year
1962 (64 years ago)
PAC ID
3971647611
Professional Enrollment ID
I20100219000112
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 216, Marengo Street, Florence, Lauderdale County, Alabama, 35630, United States

    SUITE D

    FLORENCE, AL 356306012

    Phone: (256) 767-1017

    Fax: (256) 767-1018

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 35630)

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Reviews

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Frequently asked questions

What is Unknown Individual's NPI number?
Unknown Individual's NPI is 1902849797 — the number used across U.S. healthcare to identify this provider.
Who updates status for Unknown Individual?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
What kind of doctor is Unknown Individual?
Unknown Individual is associated with Dermatology Physician in the directory — Clinical services aligned with this taxonomy classification.
What locale is associated with Unknown Individual?
Directory geography for Unknown Individual centers on Florence, Alabama.
Does Unknown Individual accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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