Provider Demographics
NPI:1801064522
Name:FIXLER DERMATOLOGY, INC.
Entity type:Organization
Organization Name:FIXLER DERMATOLOGY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ZELMAN
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:FIXLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:513-831-3003
Mailing Address - Street 1:231 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:OH
Mailing Address - Zip Code:45150-1123
Mailing Address - Country:US
Mailing Address - Phone:513-831-3003
Mailing Address - Fax:513-831-3178
Practice Address - Street 1:231 MAIN ST
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:OH
Practice Address - Zip Code:45150-1123
Practice Address - Country:US
Practice Address - Phone:513-831-3003
Practice Address - Fax:513-831-3178
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-15
Last Update Date:2008-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35019343207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHF10101461Medicare UPIN
OHA69696Medicare UPIN