Organization
SUMMIT DERMATOLOGY AND AESTHETICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN RICHARDSON (PARTNER)
(503) 858-3642
Entity
Organization
Contact information
Practice address
1910 E BARNETT RD STE 101, MEDFORD, OR 97504-8672
(541) 200-2022
Mailing address
1910 E BARNETT RD STE 101, MEDFORD, OR 97504-8672
(541) 200-2022
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Enumeration date
01/11/2024
Last updated
10/29/2024
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