Organization
CAMELBACK DERMATOLOGY & SKIN SURGERY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY LEE ROMINE (PRACTICE ADMINISTRATOR)
(602) 954-7546
Entity
Organization
Contact information
Practice address
4512 N 40TH ST, PHOENIX, AZ 85018-3600
(602) 954-7546
(602) 952-2941
Mailing address
4512 N 40TH ST, PHOENIX, AZ 85018-3600
(602) 954-7546
(602) 952-2941
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
31198
AZ
207ND0101X
MOHS-Micrographic Surgery Physician
31198
AZ
207NS0135X
Procedural Dermatology Physician
31198
AZ
Other
Enumeration date
01/30/2007
Last updated
11/14/2014
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