Healthcare Provider Details

I. General information

NPI: 1679656672
Provider Name (Legal Business Name): BARRETT & GEISS DERMATOLOGY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2006
Last Update Date: 08/11/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 N EWING ST
LANCASTER OH
43130-3307
US

IV. Provider business mailing address

112 N EWING ST
LANCASTER OH
43130-3307
US

V. Phone/Fax

Practice location:
  • Phone: 740-687-1177
  • Fax: 740-687-1661
Mailing address:
  • Phone: 740-687-1177
  • Fax: 740-687-1661

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number35030272
License Number StateOH

VIII. Authorized Official

Name: DR. JAMES L BARRETT
Title or Position: PRESIDENT
Credential: M.D.
Phone: 740-687-1177