Organization · Type 2 NPI
Eagle Dermatology, PLLC
Dermatology Physician · Eagle, ID
Practice location
323 E Riverside Dr Ste 234
Eagle, ID 83616-6865
Fax (208) 391-2130
Mailing address
372 S Eagle Rd # 126
Eagle, ID 83616-5908
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dermatology Physician Primary | 207N00000X | O-1094 (ID) |
| MOHS-Micrographic Surgery Physician | 207ND0101X | O-1094 (ID) |
| Dermatopathology Physician | 207ND0900X | O-1094 (ID) |
| Clinical & Laboratory Dermatological Immunology Physician | 207NI0002X | O-1094 (ID) |
| Pediatric Dermatology Physician | 207NP0225X | O-1094 (ID) |
| Procedural Dermatology Physician | 207NS0135X | O-1094 (ID) |
Dermatology Physician: A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis an…
Another provider at this address
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About NPI 1417456385
Eagle Dermatology, PLLC's National Provider Identifier is 1417456385, issued on Feb 6, 2018. The primary taxonomy on file is Dermatology Physician (207N00000X), and the practice location is in Eagle, ID. The record was last updated on Feb 6, 2018.