Individual
DR. PATRICIA I CEBALLOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
830 AINSWORTH DR, PRESCOTT, AZ 86301-1630
(928) 777-5800
(928) 776-0405
Mailing address
801 YORK ST, MANITOWOC, WI 54220-4630
(920) 663-9008
(920) 684-1439
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
62481
AZ
207ND0101X
MOHS-Micrographic Surgery Physician
62481
AZ
207NS0135X
Procedural Dermatology Physician
62481
AZ
207ZD0900X
Dermatopathology (Pathology) Physician
62481
AZ
Other
Enumeration date
09/22/2005
Last updated
08/29/2024
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