Organization
DERMATOLOGY AND SKIN SURGERY CENTER-NEWARK LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LARRY JOHN LITTLE M.D. (OWNER)
(614) 824-4258
Entity
Organization
Contact information
Practice address
71 S TERRACE AVE, NEWARK, OH 43055-1355
(614) 595-0718
Mailing address
175 E DESHLER AVE, COLUMBUS, OH 43206-2623
(614) 824-4258
(614) 443-3578
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
35-047090
OH
Other
Enumeration date
04/01/2011
Last updated
04/20/2011
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