Organization · Type 2 NPI

Providence Dermatology LLC

Dermatology Physician · Providence, UT

NPI number 1568029957 Active

Practice location

169 N Gateway Dr Ste 100
Providence, UT 84332-9860

Other practice locations

  • 950 Medical Dr Ste 311, Brigham City, UT 84302-4724 · (435) 554-1182

Specialties and licenses

TaxonomyCodeLicense
Dermatology Physician Primary 207N00000XNone listed
MOHS-Micrographic Surgery Physician 207ND0101XNone listed

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…

2 other providers at this address

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About NPI 1568029957

Providence Dermatology LLC's National Provider Identifier is 1568029957, issued on May 22, 2019. The primary taxonomy on file is Dermatology Physician (207N00000X), and the practice location is in Providence, UT. The record was last updated on Jun 16, 2025.