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

Premiere Dermatology and Surgery, LLC

Organization Dermatology Physician · NPI 1518163310

Premiere Dermatology and Surgery, LLC provides Dermatology Physician services in Lilburn, Georgia. Licensed in Georgia. Registered with an NPI since 2007.

Licensed in
GA
In the registry since
2007
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

4650 Stone Mountain Hwy
Lilburn, GA 30047 Not confirmed with CMS for 11 years — call before visiting
Phone: (678) 344-2450
Fax: (678) 344-2501
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X · Licence 39318 (GA)

Record details

NPI number1518163310
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Paul Boutte — Practice Manager · (404) 218-9671
Other names Premere Dermatology And Surgery, Llc
NPI enumeratedJune 27, 2007
Last updated in NPPESJune 17, 2015
Mailing address4650 Stone Mountain Hwy, Lilburn, GA 30047

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