Organization
WEST OHIO DERMATOLOGY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL R HEAPHY SR. MD (PRESIDENT)
(419) 229-6781
Entity
Organization
Contact information
Practice address
750 W HIGH ST STE 300, LIMA, OH 45801-2967
(419) 229-6781
(419) 229-3490
Mailing address
750 W HIGH ST STE 300, LIMA, OH 45801-2967
(419) 229-6781
(419) 229-3490
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
35040604
OH
207ND0101X
MOHS-Micrographic Surgery Physician
35040604
OH
207NS0135X
Procedural Dermatology Physician
35040604
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0340321
—
OH
Enumeration date
09/07/2006
Last updated
12/31/2019
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