Organization
NORTHEAST DERMATOLOGY AND COSMETIC SURGERY CENTER
Active
Organization
NORTHEAST DERMATOLOGY AND COSMETIC SURGERY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOEL BAIN HERRON M.D. (MEDICAL DIRECTOR)
(614) 473-9519
Entity
Organization
Contact information
Practice address
925 NORTH HAMILTON ROAD, SUITE 100, GAHANNA, OH 43230-4566
(614) 473-9519
(614) 473-9543
Mailing address
925 NORTH HAMILTON ROAD, SUITE 100, GAHANNA, OH 43230-4566
(614) 473-9519
(614) 473-9543
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
35078963
OH
Other
Enumeration date
07/31/2006
Last updated
11/29/2007
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