Dereka McKissack McKissack

Practice location

Address

374 N Deshon Rd STE D, Stone Mountain, GA 30087-4827

Phone

(770) 469-4192

Fax

(770) 469-4195

Registered specialties

Registry record

NPI

1124469705

Entity type

Individual

Sex (as registered)

Female

NPI issued

11 Jul 2013

Record last updated

11 Jul 2013

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.