Dr. Jeremy R Etzkorn
Dermatologist Procedural Dermatology MOHS-Micrographic Surgeon
3600 Spruce Street 2 Maloney Bldg
Philadelphia
, Pennsylvania 19104
Dr. Jeremy R Etzkorn
Dermatologist Procedural Dermatology MOHS-Micrographic Surgeon
3600 Spruce Street 2 Maloney Bldg
Philadelphia
, Pennsylvania 19104
(215) 662-2737
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About
Features
Specialties
- Dermatologist
- MOHS-Micrographic Surgeon
- Procedural Dermatology
Languages spoken
- English
Location
First Address
- Dr. Jeremy R Etzkorn
- 3600 Spruce Street 2 Maloney Bldg
- Philadelphia, PA
- Zip : 19104
- Phone : (215) 662-2737
Second Address
- Dr. Jeremy R Etzkorn
- 3600 Spruce Street 2 Maloney Bldg
- Philadelphia, PA
- Zip : 19104
- Phone : (215) 662-2737
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207N00000X | Dermatologist | MD451783 | PA |
| N | 207N00000X | Dermatologist | ME110688 | FL |
| N | 207ND0101X | MOHS-Micrographic Surgeon | ME110688 | FL |
| N | 207NS0135X | Procedural Dermatology | ME110688 | FL |
National Provider Identifier
| NPI | 1497915730 |
|---|---|
| Provider Name | Dr. Jeremy R Etzkorn |
| First Address | Philadelphia, PA 19104 |
| Second Address | Philadelphia, PA 19104 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 10/06/2008 |
| Last Update Date | 15/05/2014 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.