Provider Demographics
NPI:1285396978
Name:SKIN FIRM, LLC
Entity type:Organization
Organization Name:SKIN FIRM, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TABITHA
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:MELVIN
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:740-208-2550
Mailing Address - Street 1:1005 E TEMPLE ST
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON COURT HOUSE
Mailing Address - State:OH
Mailing Address - Zip Code:43160-3600
Mailing Address - Country:US
Mailing Address - Phone:740-208-2550
Mailing Address - Fax:740-853-4229
Practice Address - Street 1:1005 E TEMPLE ST
Practice Address - Street 2:
Practice Address - City:WASHINGTON COURT HOUSE
Practice Address - State:OH
Practice Address - Zip Code:43160-3600
Practice Address - Country:US
Practice Address - Phone:740-208-2550
Practice Address - Fax:740-431-4447
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-10
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty