DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MR. MYLES SIDNEY JERDAN, MEDICAL DOCTOR

Active

Dermatology · LAGRANGE, GA

Registration Details

NPI Number
1770549701
Provider Type
Individual
Gender
Male
NPI Issued
Apr 26, 2006 (19.988412974083 yrs)
Last Updated
Aug 28, 2020
Licenses
60136 (TN)
D30796 (GA)
030796 (GA)
30796 (GA)

Practice Information

Address
1605 WHITESVILLE ST
LAGRANGE, GA, 302405903
Browse GA providers · Browse ZIP 30240
Phone
8772313376
Fax
8505228354
Primary Specialty
Dermatology
207N00000X
Additional Specialty
Dermatology
Additional Specialty
Dermatopathology
Additional Specialty
Dermatology

Other Dermatology Providers in LAGRANGE, GA

Name Credential NPI
MR. GARIN DANIEL BARTH MD 1770518045
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.