ENCORE DERMATOLOGY NPI 1912220799

NPI Information

ENCORE DERMATOLOGY is a medical specialty clinic center in Columbus, OH. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). ENCORE DERMATOLOGY NPI is 1912220799. The provider is registered as an organization entity type.

The provider's business location address is:

4900 GETTYSBURG RD
COLUMBUS, OH
ZIP 43220-520
Phone: (614) 442-0100

The provider's authorized official is Gwyn R Londeree .
The authorized official title is Owner and has the following contact phone number (614) 442-1012.

The CLIA number assigned to this NPI record is 36D2004632 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 3/8/2010 and was last updated on 3/8/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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