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NPI Code Detail

MEDICARE: DERMATOLOGISTS OF SOUTHWEST OHIO, LLC.

MEDICARE: DERMATOLOGISTS OF SOUTHWEST OHIO, LLC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207W00000XOphthalmology Physician1801819883OH
2207N00000XDermatology Physician1801819883OH

General Provider Information

NPI Number : 1801819883
Entity Type Code : Organization
Provider Name (Legal Business Name) : DERMATOLOGISTS OF SOUTHWEST OHIO, LLC.
Provider Business Mailing Address
First Line : PO BOX 746747
Second Line :
City : ATLANTA
State : GA
Zip : 30374-6747
Country : US
Telephone Number : 866-680-8505
Fax Number : 937-436-4156
Provider Business Practice Location Address
First Line : 5300 FAR HILLS AVE
Second Line :
City : DAYTON
State : OH
Zip : 45429-2347
Country : US
Telephone Number : 937-433-7536
Fax Number : 937-433-9612
Authorized Official
Title or Position : C.E.O.
Name : WILLIAM BUTLER
Credential :
Telephone Number : 615-416-3270
Provider Enumeration Date : 07/25/2006
Last Update Date : 01/07/2026

Similar Medicare Providers

1639197049 — MARK E. FENSTER M.D.
Practice Location Address:
5300 FAR HILLS AVE.
DAYTON, OH
45429-2347
Practice Phone: 937-433-7536
Practice Fax: 937-433-9612
1871511188 — JOHN C. LEPAGE M.D.
Practice Location Address:
5300 FAR HILLS AVE.
DAYTON, OH
45429-2347
Practice Phone: 937-433-7536
Practice Fax: 937-433-9612
1144248493 — PHILLIP K. HALL M.D.
Practice Location Address:
5300 FAR HILLS AVE.
DAYTON, OH
45429-2347
Practice Phone: 937-433-7536
Practice Fax: 937-433-9612
1558381806 — ROBERT A PALACIO M.D.
Practice Location Address:
5300 FAR HILLS AVE.
DAYTON, OH
45429-2347
Practice Phone: 937-433-7536
Practice Fax: 937-433-9612
1437169737 — DR. BRIAN W. RUSS M.D.
Practice Location Address:
5300 FAR HILLS AVE
DAYTON, OH
45429-2347
Practice Phone: 937-312-3830
Practice Fax: 937-433-9612
1689771933 — SHANNON MICHELLE NOVOSAD VERMA M.D.
Practice Location Address:
5300 FAR HILLS AVENUE
DAYTON, OH
45429-2347
Practice Phone: 937-433-7536
Practice Fax: 937-433-9612

Directions to “DERMATOLOGISTS OF SOUTHWEST OHIO, LLC. ” Practice Location

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