Etzkorn, Jeremy R

Etzkorn, Jeremy R is an individual health care provider with primary practice located at 3600 Spruce Street 2 Maloney Bldg, Philadelphia PA 19104. He recently has 4 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Dermatology, Allopathic & Osteopathic Physicians / Procedural Dermatology, Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery. Allopathic & Osteopathic Physicians / Dermatology is his primary health care specialty. Etzkorn, Jeremy R can be contacted via phone (215) 662-2737.

Contact Information

Primary practice address
3600 Spruce Street 2 Maloney Bldg Philadelphia PA 19104
Phone: (215) 662-2737
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X TRN122223 Florida
Allopathic & Osteopathic Physicians / Dermatology 207N00000X ME110688 Florida
Allopathic & Osteopathic Physicians / Procedural Dermatology 207NS0135X ME110688 Florida
Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery 207ND0101X ME110688 Florida
Allopathic & Osteopathic Physicians / Dermatology 207N00000X MD451783 Pennsylvania

Profile Details

NPI number 1497915730
LBN Legal business name Etzkorn, Jeremy R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 10th, 2008
Last updated May 15th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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