ACTINODERMATOLOGY LTD
Dermatology at Southern Ave, Tempe, AZ

License number
Arizona 7979
Category
Osteopathic Medicine
Type
Dermatology
Owner
Name: DR. JERRY A PONITCH M.D.
Title: PRESIDENT
Phone: (480) 839-1767
Address
Address
2600 E Southern Ave #A-2, Tempe, AZ 85282
National Provider ID: 1063695252
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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ACTINODERMATOLOGY, LTD

Tempe, AZ

Status:
Inactive
Doing business as:
Actinodermatology Limited
Inactive reason:
Delinquent annual report
Registration:
Jan 6, 1978
Inactive since:
Dec 16, 2014
Phone:
(480) 839-1767 (Phone)
Addresses:
2600 E Southern Ave A-2, Tempe, AZ 85282 (Physical)
2600 E Southern Ave, Tempe, AZ 85282
State ID:
-0113660-9
Expiration:
PERPETUAL
President:
Jerry A Ponitch Md (President), 2600 E Southern Ave STE A-2, Tempe, AZ 85282 (Physical)
Categories:
Physicians & Surgeons
Open Hours:
Open Evenings
Specialties:
Skin Diseases
Products:
Actinodermatology, L.T.D., Hair, Hyperpigmentation, ...
Additional:
Complete Dermatologic Care, In Practice for Over 20 Years

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