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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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