RUSSELLVILLE DERMATOLOGY CLINIC PA
NPI 1477529436
Dermatology - Procedural Dermatology in Russellville, AR
NPI Status: Active since February 28, 2006
Contact Information
1602 W MAIN ST
RUSSELLVILLE, AR
ZIP 72801
Phone: (479) 968-6969
Fax: (479) 968-4290
- Organization
- Dermatology
- Procedural Dermatology
- CLIA Number: 04D2108006
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 02-21-2027
About RUSSELLVILLE DERMATOLOGY CLINIC PA
This page provides the complete NPI Profile along with additional information for Russellville Dermatology Clinic Pa, a provider established in Russellville, Arkansas operating as a Dermatology, focusing in procedural dermatology . The healthcare provider is registered in the NPI registry with number 1477529436 assigned on February 2006. The practitioner's primary taxonomy code is 207NS0135X with license number MC0841 (AR). The provider is registered as an organization and their NPI record was last updated 3 years ago. The organization operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The authorized official of this NPI record is Dr. William W Galloway M.d. (President / Owner)
- NPI
- 1477529436
- Provider Name
- RUSSELLVILLE DERMATOLOGY CLINIC PA
- Entity Type
- Organization
- Location Address
- 1602 W MAIN ST RUSSELLVILLE, AR 72801
- Location Phone
- (479) 968-6969
- Location Fax
- (479) 968-4290
- Mailing Address
- PO BOX 843 RUSSELLVILLE, AR 72811
- Mailing Phone
- (479) 968-6969
- Mailing Fax
- (479) 968-4290
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 02-28-2006
- Last Update Date
- 03-07-2023
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Dermatology Procedural Dermatology
- Taxonomy Code
- 207NS0135X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- MC0841
- License State
- AR
- Taxonomy Description
- Procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers).
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 110005002 | MEDICAID (05) | AR |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 04D2108006
- Facility Type
- Physician Office
- Certificate Effective Date
- February 22, 2025
- Certificate Expiration Date
- February 21, 2027
- Laboratory Director
- DR. NEYLON PILKINGTON
- Certificate Type
- Certificate of Compliance
- Certificate Type Description
- This CLIA certificate is issued to Russellville Dermatology Clinic Pa after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 4 | 7 | 7 | 5 | 2 | 9 | 4 | 3 | 6 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 4 | 14 | 7 | 10 | 2 | 18 | 4 | 6 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 4 + 1 + 4 + 7 + 1 + 0 + 2 + 1 + 8 + 4 + 6 + 24 = 64 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 64 = 6 | 6 | ||||||||
The NPI number 1477529436 is valid because the calculated check digit 6 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following provider is registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1811963861 | DR. WILLIAM W GALLOWAY M.D. Individual | Dermatology (Procedural Dermatology) | 1602 W MAIN ST RUSSELLVILLE, AR 72801 (479) 968-6969 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1477529436, enumerated in the NPI registry as an "organization" on February 28, 2006
The provider is located at 1602 W Main St Russellville, Ar 72801 and the phone number is (479) 968-6969
This medical organization specializes in Dermatology with taxonomy code 207NS0135X with a focus in Procedural Dermatology
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
The provider's CLIA number is 04D2108006 for a "physician office" facility with a CLIA Certificate of Compliance. This CLIA certificate is issued after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing..
This NPI record was last updated on February 28, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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