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General NPI Number Information
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NPI Number | 1306084082
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Entity Type | Organization
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Legal Business Name | DERMATOLOGY OF CENTRAL OHIO, INC
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Dates
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Enumeration Date | 02/03/2009
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Last Update Date | 02/03/2009
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Provider Practice Location Address
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Address Line | 161 CLINT DRIVE SUITE 100
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City | PICKERINGTON
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State | OH
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Zip | 43147
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Country | US
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Telephone | 614-866-8535
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Fax |
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Provider Business Mailing Address
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Address Line | 161 CLINT DRIVE SUITE 100
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City | PICKERINGTON
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State | OH
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Zip | 43147
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Country | US
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Telephone | 614-866-8535
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Fax |
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Authorized Official
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Title or Position | DERMATOLOGIST
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Name | DR. JOHN MICHAEL HOLSINGER
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Credential | D.O.
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Telephone | 614-832-2403
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 34008980
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License Number State | OH
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