Active NPI
Tri County Dermatology Inc
- Specialist
- Canton, OH
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 34005284
- Legal business name
- TRI COUNTY DERMATOLOGY INC
- Practice address
- 4240 Munson St NW
Suite C
Canton, OH 44718-2981 - Phone
- (330) 492-2327
- Fax
- (330) 492-0953
- NPI assigned
- Aug 7, 2007
- Last updated
- Aug 7, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Monte E Fox, D.O.
- Title
- Vice President
- Phone
- (330) 492-2327
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 34005284 | OH | Primary |
Addresses
Primary practice location
4240 Munson St NW
Suite C
Canton, OH 44718-2981
Mailing address
4240 Munson St NW
Suite C
Canton, OH 44718-2981
Phone (330) 492-2327
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0972514 | Medicaid | OH |
National Provider Directory
National Provider Directory- Tax ID family
- Tri County Dermatology Inc
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Specialist
- Cuyahoga Falls, OH
- NPI 1013108745
-
- Dermatology Physician
- Ravenna, OH
- NPI 1184816050
Locations
4240 Munson St NW
Ste C
Canton, OH 44718
Phone (330) 492-2327
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Procedural Dermatology Physician
- Canton, OH
- NPI 1417971367
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1186444800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1186444800000",
"number": "1700077542",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4240 MUNSON ST NW",
"address_2": "SUITE C",
"city": "CANTON",
"state": "OH",
"postal_code": "447182981",
"telephone_number": "330-492-2327",
"fax_number": "330-492-0953"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4240 MUNSON ST NW",
"address_2": "SUITE C",
"city": "CANTON",
"state": "OH",
"postal_code": "447182981",
"telephone_number": "330-492-2327",
"fax_number": "330-492-0953"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TRI COUNTY DERMATOLOGY INC",
"organizational_subpart": "NO",
"enumeration_date": "2007-08-07",
"last_updated": "2007-08-07",
"status": "A",
"authorized_official_last_name": "FOX",
"authorized_official_first_name": "MONTE",
"authorized_official_middle_name": "E",
"authorized_official_title_or_position": "VICE PRESIDENT",
"authorized_official_telephone_number": "330-492-2327",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "D.O."
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "OH",
"license": "34005284",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0972514",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Canton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.