Provider Demographics
NPI:1902873250
Name:DERMATOLOGY ASSOCIATES OF ASHEVILLE PA
Entity Type:Organization
Organization Name:DERMATOLOGY ASSOCIATES OF ASHEVILLE PA
Other - Org Name:JERRY N ARIAIL MD PA
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:NOLAN
Authorized Official - Last Name:ARIAIL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:828-252-3576
Mailing Address - Street 1:390 SOUTH FRENCH BROAD AVENUE
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-4301
Mailing Address - Country:US
Mailing Address - Phone:828-252-3576
Mailing Address - Fax:828-252-5419
Practice Address - Street 1:390 SOUTH FRENCH BROAD AVENUE
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-4301
Practice Address - Country:US
Practice Address - Phone:828-252-3576
Practice Address - Fax:828-252-5419
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8911703Medicaid
NC201823BMedicare ID - Type Unspecified
C80915Medicare UPIN