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EASTSIDE DERMATOLOGY INC. NPI 1063564664


NPI Information

NPI: 1063564664
Provider Name: EASTSIDE DERMATOLOGY, INC.

Doing Business As: EASTSIDE DERMATOLOGY & SKIN CARE CENTER, EASTSIDE DERMATOLOGY OF HILLA

Classification: Dermatology - 207NS0135X
Entity Type: Organization

Specialization: Procedural Dermatology

Address:
150 TAYLOR STATION RD
SUITE 250
COLUMBUS, OH
ZIP 43213
Phone: (614) 863-3222
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EASTSIDE DERMATOLOGY, INC. is a procedural dermatology dermatology in Columbus, OH. The provider is procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers). EASTSIDE DERMATOLOGY, INC. NPI is 1063564664. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Eastside Dermatology & Skin Care Center, Eastside Dermatology Of Hilla.

The provider's business location address is:

150 TAYLOR STATION RD
SUITE 250
COLUMBUS, OH
ZIP 43213
Phone: (614) 863-3222
Fax: (614) 863-4450

The provider's authorized official is Alan J Parks .
The authorized official title is President and has the following contact phone number (614) 863-3222.

The enumeration date for this NPI number is 1/17/2007 and was last updated on 10/16/2008.


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:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207NS0135XDermatologyProcedural Dermatology35054686OHIOYes

Other Identifiers

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

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1CM5822MEDICARE PINOHIO
2000000214662OTHEROHIOSTEPHANIE COTELL ANTHEM I
31598751653OTHEROHIOALAN PARKS NPI
4A16830MEDICARE UPINOHIO
5C04059851MEDICARE ID-TYPE UNSPECIFIEDOHIOSTEPHANIE COTELL MEDICARE
6B53572MEDICARE UPINOHIO
7000000118991OTHEROHIOALAN PARKS ANTHEM ID
81215972484OTHEROHIOYAHNA T SMITH CNP NPI
99263901MEDICARE ID-TYPE UNSPECIFIEDOHIOALAN PARKS MEDICARE
101922093459OTHEROHIOSTEPHANIE COTELL NPI
112285218MEDICAIDOHIO
120665856MEDICAIDOHIO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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