Organization
DERMATOLOGY ASSOCIATES OF CINTI INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL A LUCKY MD (PRESIDENT)
(513) 791-6161
Entity
Organization
Contact information
Practice address
10506 MONTGOMERY ROAD, #402, CINCINNATI, OH 45242
(513) 791-6161
(513) 791-4004
Mailing address
10700 MONTGOMERY ROAD, #207, CINCINNATI, OH 45242
(513) 247-9986
(513) 247-9987
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0696493
—
OH
Enumeration date
03/08/2007
Last updated
09/15/2011
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