Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Integrated Dermatology of Granville, LLC

Organization Dermatology Physician · NPI 1609204908

Integrated Dermatology of Granville, LLC provides Dermatology Physician services in Granville, Ohio. Registered with an NPI since 2013.

In the registry since
2013
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1959 Newark Granville Rd
Granville, OH 43023-9171
Phone: (740) 587-0778
Fax: (740) 587-0601
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X

Record details

NPI number1609204908
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jeffrey Queen — Owner · (561) 314-2000
NPI enumeratedOctober 23, 2013
Last updated in NPPESJanuary 18, 2019
Mailing address4700 Exchange Ct Ste 110, Boca Raton, FL 33431-4450

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