Individual
DR. TISHA GAYETTE DELLOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1330 COSHOCTON AVE, MOUNT VERNON, OH 43050-1440
(740) 393-9770
(740) 399-3134
Mailing address
700 ACKERMAN RD STE 2120, COLUMBUS, OH 43202-1559
(740) 393-9770
(740) 399-3134
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
34.008976
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2938558
—
OH
Enumeration date
10/14/2008
Last updated
11/29/2022
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