Organization
SUBURBAN DERMATOLOGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JOSEPHINE NKECHI OKWECHIME MD (OWNER)
(317) 418-3227
Entity
Organization
Contact information
Practice address
1542 S DIXON RD, KOKOMO, IN 46902-7318
(317) 418-3227
(317) 844-5746
Mailing address
1542 S DIXON RD, KOKOMO, IN 46902-7318
(317) 418-3227
(317) 844-5746
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
01052094A
IN
Other
Enumeration date
03/12/2012
Last updated
04/18/2012
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