Organization
DERMATOLOGY ALLERGY GENERAL PHYSICIANS OF OHIO INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. THERESA LYNN MCFARLAND (CORPORATION SECRETARY)
(937) 233-0748
Entity
Organization
Contact information
Practice address
37 NORTH PLAZA BOULEVARD, CHILLICOTHE, OH 45601-1759
(740) 772-6600
(740) 775-9863
Mailing address
5212 BRANDT PIKE, SUITE A, HUBER HEIGHTS, OH 45424-6138
(937) 233-0748
(937) 233-6086
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
35 04 3565M
OH
207R00000X
Internal Medicine Physician
Primary
35 05 8434M
OH
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
34003765F
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000011382
ANTHEM PIN
OH
01
—
000000011390
ANTHEM PIN
OH
01
—
000000011437
ANTHEM PIN
OH
01
—
368588672036
MMO PIN
OH
01
—
485805933016
MEDICAL MUTUAL
OH
01
—
485805933027
MEDICAL MUTUAL PIN
—
01
—
9190161
PTAN
OH
Enumeration date
06/06/2007
Last updated
10/05/2009
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