Integrated Dermatology of Granville, LLC

NPI #1609204908 in Granville, Ohio

Provider Information

NPI Number: 1609204908
Entity Type: Organization
Organization Name: Integrated Dermatology of Granville, LLC
Primary Specialty: Dermatology
Enumeration Date: Oct 23, 2013
Last Updated: Jan 18, 2019

Practice Location

Address: 1959 NEWARK GRANVILLE RD
City: Granville
State: Ohio
ZIP Code: 43023-9171
Phone: (740) 587-0778

Authorized Official

Name: JEFFREY D. QUEEN
Title: OWNER
Phone: (561) 314-2000

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dermatology	207N00000X	Primary

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