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

Epiphany Dermatology of Georgia, LLC

Organization Dermatology Physician · NPI 1265544357

Epiphany Dermatology of Georgia, LLC is a Dermatology Physician in Fayetteville, Georgia. Registered with an NPI since 2006.

In the registry since
2006
Specialties on file
3
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

874 Lanier Ave W Ste 270
Fayetteville, GA 30214-7617
Phone: (770) 251-5111
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X
MOHS-Micrographic Surgery Physician Taxonomy 207ND0101X
Procedural Dermatology Physician Taxonomy 207NS0135X

Record details

NPI number1265544357
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Gheorghe Pusta — Executive Director · (512) 628-0465
Other names Epiphany Dermatology
NPI enumeratedAugust 31, 2006
Last updated in NPPESMarch 19, 2025
Certification dateMarch 19, 2025
Mailing address7300 Ranch Road 2222, Building 1, Ste 200, Austin, TX 78730

Other providers in Fayetteville