Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Colquitt Regional Dermatology, LLC

Organization Dermatology Physician · NPI 1649683897

Colquitt Regional Dermatology, LLC is a Dermatology Physician in Moultrie, Georgia. Registered with an NPI since 2014.

In the registry since
2014
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

760 26th Ave SE
Moultrie, GA 31768-6799
Phone: (229) 502-9710
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X

Record details

NPI number1649683897
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationColquitt Regional Medical, Inc
Authorized official Amanda Roberts — Provider Enrollment Coordinator · (229) 891-9131
NPI enumeratedJune 5, 2014
Last updated in NPPESJuly 21, 2022
Mailing address760 26th Ave Se, Moultrie, GA 31768-6799

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