Organization · Type 2 NPI

Idaho Falls Dermatology P A

Specialist · Idaho Falls, ID

NPI number 1487700464 Active

Practice location

2001 S Woodruff Ave, Ste 12A
Idaho Falls, ID 83404-6374

Call (208) 522-8945 Map

Specialties and licenses

TaxonomyCodeLicense
Specialist Primary 174400000X5809M (ID)

Specialist: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

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About NPI 1487700464

Idaho Falls Dermatology P A's National Provider Identifier is 1487700464, issued on Jan 25, 2007. The primary taxonomy on file is Specialist (174400000X), and the practice location is in Idaho Falls, ID. The record was last updated on Jul 5, 2016.