The Gallery of Dermatology and Advanced Aesthetics
NPI 1205408630ActiveOrganization· Dermatology· Lake Charles, LA
Dermatology in Lake Charles, Louisiana, registered in NPPES in July 2021. The authorized official on file is Kerri Elizabeth Davis-Fontenot, MD, Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1205408630 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jul 14, 2021 |
| Last updated in NPPES | Jul 14, 2021 |
| Certified by provider | Jul 14, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dermatology Primary | 207N00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (LA) |
|---|
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