MEDICARE: SKIN CANCER CENTER INC

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
1	261QA1903X	Ambulatory Surgical Clinic/Center

General Provider Information

NPI Number	:	1871526004
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SKIN CANCER CENTER INC

Provider Business Mailing Address
First Line	:	3024 BURNET AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45219-2420
Country	:	US
Telephone Number	:	513-221-2828
Fax Number	:	513-872-5721

Provider Business Practice Location Address
First Line	:	3024 BURNET AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45219-2420
Country	:	US
Telephone Number	:	513-221-2828
Fax Number	:	513-872-5721

Authorized Official
Title or Position	:	DIRECTOR
Name	:	DR. BRETT M. COLDIRON
Credential	:	M.D.
Telephone Number	:	513-221-2828

Provider Enumeration Date	:	07/09/2006
Last Update Date	:	08/13/2025

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