Provider Demographics
NPI:1942433065
Name:COLUMBUS SKIN SURGERY CENTER, INC.
Entity Type:Organization
Organization Name:COLUMBUS SKIN SURGERY CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:L
Authorized Official - Last Name:THORNTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-803-1445
Mailing Address - Street 1:6670 PERIMETER DR
Mailing Address - Street 2:SUITE 260
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-8056
Mailing Address - Country:US
Mailing Address - Phone:614-389-2200
Mailing Address - Fax:
Practice Address - Street 1:6670 PERIMETER DR
Practice Address - Street 2:SUITE 260
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43016-8056
Practice Address - Country:US
Practice Address - Phone:614-389-2200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-25
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC127136207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic SurgeryGroup - Single Specialty