Organization · Type 2 NPI
Dermatology of Eastern Idaho PA
Specialist · Rigby, ID
NPI number
1548259161
Active
Practice location
703 Rigby Lake Dr
Rigby, ID 83442-5192
Fax (208) 745-0212
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Specialist Primary | 174400000X | M-6569 (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.
4 other providers at this address
About NPI 1548259161
Dermatology of Eastern Idaho PA's National Provider Identifier is 1548259161, issued on Oct 17, 2005. The primary taxonomy on file is Specialist (174400000X), and the practice location is in Rigby, ID. The record was last updated on Jun 30, 2010.