Provider Demographics
NPI:1578961496
Name:FOREFRONT DERMATOLOGY, S.C.
Entity Type:Organization
Organization Name:FOREFRONT DERMATOLOGY, S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BETSY
Authorized Official - Middle Name:J
Authorized Official - Last Name:WERNLI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:960-482-0671
Mailing Address - Street 1:188 STATE ROAD 129 S, SUITE B
Mailing Address - Street 2:BATESVILLE MEDICAL ARTS BLDG
Mailing Address - City:BATESVILL
Mailing Address - State:IN
Mailing Address - Zip Code:47006-7626
Mailing Address - Country:US
Mailing Address - Phone:812-222-0203
Mailing Address - Fax:812-222-2040
Practice Address - Street 1:188 STATE ROAD 129 S
Practice Address - Street 2:SUITE B
Practice Address - City:BATESVILLE
Practice Address - State:IN
Practice Address - Zip Code:47006
Practice Address - Country:US
Practice Address - Phone:812-222-0203
Practice Address - Fax:812-222-0204
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-09
Last Update Date:2018-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty