Organization
DERMATOLOGY & SURGERY OF SOUTHERN OHIO, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONI PROFT (OFFICE ADMINISTRATOR)
(513) 858-6900
Entity
Organization
Contact information
Practice address
7132 CINCINNATI DAYTON RD, SUITE 200, LIBERTY TOWNSHP, OH 45069-1775
(513) 858-6900
(513) 858-6903
Mailing address
PO BOX 633048, CINCINNATI, OH 45263-3048
(513) 858-6900
(513) 858-6903
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
035060409
OH
207ND0101X
MOHS-Micrographic Surgery Physician
035060409
OH
207ND0900X
Dermatopathology Physician
035060409
OH
207NP0225X
Pediatric Dermatology Physician
035060409
OH
207NS0135X
Procedural Dermatology Physician
035060409
OH
Other
Enumeration date
07/20/2010
Last updated
07/20/2010
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