Dermatology of Southeastern Ohio, Inc.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

34004301 Issued in OH

Legal business name

DERMATOLOGY OF SOUTHEASTERN OHIO, INC.

Practice address

751 Forest Ave Ste 201
Zanesville, OH 43701

Phone

(740) 454-7546

Fax

(740) 454-6760

NPI assigned

Jan 23, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. John P. Hibler, D.O.

Title

President Owner

Phone

(740) 454-7546

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Joel Bain Herron, MD

  • Dermatology Physician
  • Gahanna, OH
  • NPI 1154323681
  NPD (past)
• Spencer A Hamner, PA-C

  • Surgical Physician Assistant
  • Lincoln, NE
  • NPI 1598853715
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534291200000",
    "number": "1295889574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "751 FOREST AVE STE 201",
            "city": "ZANESVILLE",
            "state": "OH",
            "postal_code": "437012875",
            "telephone_number": "740-454-7546",
            "fax_number": "740-454-6760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 FOREST AVE STE 201",
            "city": "ZANESVILLE",
            "state": "OH",
            "postal_code": "43701",
            "telephone_number": "740-454-7546",
            "fax_number": "740-454-6760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY OF SOUTHEASTERN OHIO, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-23",
        "last_updated": "2018-08-15",
        "status": "A",
        "authorized_official_last_name": "HIBLER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "PRESIDENT OWNER",
        "authorized_official_telephone_number": "740-454-7546",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "OH",
            "license": "34004301",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0712241",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lindsey K Denney, AAS, QMHS
• Allison B Dennis, BA, LPC
• Chelsey Dennis, LSW
• Kiera Jane Dennis, L.P.N
• Autumn Dent
• Carol Derwacter, C.N.P.
• Christi Lynn Desender, M.ED.
• Ashley N. Devoll
• Brittany Dawn Devoll, LPN
• Kiley Devoll

• Dermatology Physician in Zanesville, OH
• Providers in Zanesville, OH by specialty
• Dermatology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.