Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Live Oak Dermatology PC

Organization MOHS-Micrographic Surgery Physician · NPI 1609654466

Live Oak Dermatology PC is an MOHS-Micrographic Surgery Physician in Fairview, Pennsylvania. Works from 2 locations. Registered with an NPI since 2023.

In the registry since
2023
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

7176 W Ridge Rd
Fairview, PA 16415-2027
Phone: (814) 413-7997
Fax: (814) 413-7998
Show map & directions

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

Additional practice locations (1)

  • 118 E Plum St, Edinboro, PA 16412-2252 — (814) 413-7997

Specialties & licences

MOHS-Micrographic Surgery Physician (primary) Taxonomy 207ND0101X

Record details

NPI number1609654466
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Michael Zaycosky — Owner · (814) 413-7997
NPI enumeratedSeptember 21, 2023
Last updated in NPPESJanuary 30, 2025
Certification dateJanuary 30, 2025
Mailing address7176 W Ridge Rd, Fairview, PA 16415-2027